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3. Food insecurity and its determinants among adults in North and South India

Author

Anjali Ganpule, Kerry Ann Brown, Manisha Dubey, Nikhil Srinivasapura Venkateshmurthy, Prashant Jarhyan, Avinav Prasad Maddury, Rajesh Khatkar, Himanshi Pandey, Dorairaj Prabhakaran, and Sailesh Mohan

Subjects
Food insecurity, Indian adults, Dietary diversity, BMI, Nutrition. Foods and food supply, TX341-641, Nutritional diseases. Deficiency diseases, RC620-627
Abstract

Abstract Background Food insecurity is a major public health problem worldwide. In India, there are limited food insecurity assessment studies using a conventionally accepted method like the Food Insecurity Experience Scale (FIES), developed by the Food and Agricultural Organization (FAO). This study aims to measure food insecurity using the FIES and explore its determinants and association with body mass index (BMI) among Indian adults. Methods In a cross-sectional study, we used FIES to measure food security in a sample of 9005 adults residing in North and South India. Using questionnaires, socio-demographic factors, dietary intake and food security data were collected. The dietary diversity scores (FAO-IDDS) and food insecurity scores (FAO-FIES) were calculated. Body size was measured and BMI was calculated. Results The mean age of the study participants was 52.4 years (± 11.7); half were women and half resided in rural areas. Around 10% of the participants reported having experienced (mild or moderate or severe) food insecurity between October 2018 and February 2019. Dietary diversity (measured by FAO’s Individual Dietary Diversity Scores, IDDS) was low and half of the participants consumed ≤ 3 food groups/day. The mean BMI was 24.7 kg/m2. In the multivariate analysis, a lower IDDS and BMI were associated with a higher FIES. The place of residence, gender and wealth index were important determinants of FIES, with those residing in South India, women and those belonging to the poorest wealth index reporting higher food insecurity. Conclusion Food security is understudied in India. Our study adds important evidence to the literature. Despite having marginal food insecurity, high prevalence of low diet quality, especially among women, is disconcerting. Similar studies at the national level are warranted to determine the food insecurity situation comprehensively in India and plan appropriate policy actions to address it effectively, to attain the key Sustainable Development Goals (SDG).

Published
2023
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7. Impact of COVID-19 infection on life expectancy, premature mortality, and DALY in Maharashtra, India

Author

Guru Vasishtha, Sanjay K. Mohanty, Udaya S. Mishra, Manisha Dubey, and Umakanta Sahoo

Subjects
COVID-19, Premature mortality, Life expectancy, YPLL, DALY, Maharashtra, Infectious and parasitic diseases, RC109-216
Abstract

Abstract Background The COVID-19 infections and deaths have largely been uneven within and between countries. With 17% of the world’s population, India has so far had 13% of global COVID-19 infections and 8.5% of deaths. Maharashtra accounting for 9% of India’s population, is the worst affected state, with 19% of infections and 33% of total deaths in the country until 23rd December 2020. Though a number of studies have examined the vulnerability to and spread of COVID-19 and its effect on mortality, no attempt has been made to understand its impact on mortality in the states of India. Method Using data from multiple sources and under the assumption that COVID-19 deaths are additional deaths in the population, this paper examined the impact of the disease on premature mortality, loss of life expectancy, years of potential life lost (YPLL), and disability-adjusted life years (DALY) in Maharashtra. Descriptive statistics, a set of abridged life tables, YPLL, and DALY were used in the analysis. Estimates of mortality indices were compared pre- and during COVID-19. Result COVID-19 attributable deaths account for 5.3% of total deaths in the state and have reduced the life expectancy at birth by 0.8 years, from 73.2 years in the pre-COVID-19 period to 72.4 years by the end of 2020. If COVID-19 attributable deaths increase to 10% of total deaths, life expectancy at birth will likely reduce by 1.4 years. The probability of death in 20–64 years of age (the prime working-age group) has increased from 0.15 to 0.16 due to COVID-19. There has been 1.06 million additional loss of years (YPLL) in the state, and DALY due to COVID-19 has been estimated to be 6 per thousand. Conclusion COVID-19 has increased premature mortality, YPLL, and DALY and has reduced life expectancy at every age in Maharashtra.

Published
2021
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13. Anaemia among men in India: a nationally representative cross-sectional study

Author

Oliver Didzun, Jan-Walter De Neve, ScD, Ashish Awasthi, PhD, Manisha Dubey, PhD, Michaela Theilmann, MA, Till Bärnighausen, ProfMD, Sebastian Vollmer, ProfPhD, and Pascal Geldsetzer, ScD

Subjects
Public aspects of medicine, RA1-1270
Abstract

Summary: Background: Population-based studies on anaemia in India have mostly focused on women and children, with men with anaemia receiving much less attention despite anaemia's adverse effect on health, wellbeing, and economic productivity. This study aimed to determine the national prevalence of anaemia among men in India; how the prevalence of anaemia in men varies across India among states and districts and by sociodemographic characteristics; and whether the geographical and sociodemographic variation in the prevalence of anaemia among men is similar to that among women to inform whether anaemia reduction efforts for men should be coupled with existing efforts for women. Methods: In this cross-sectional study, we analysed data from a nationally representative household survey carried out from January, 2015, to December, 2016, among men aged 15–54 years and women aged 15–49 years in all 29 states and seven Union Territories of India. Haemoglobin concentration was measured using the portable HemoCue Hb 201+ (HemoCue AB, Ängelholm, Sweden) and a capillary blood sample. In addition to disaggregating anaemia prevalence (separately in men and women) by state and age group, we used mixed-effects Poisson regression to determine individual-level and district-level predictors of anaemia. Findings: 106 298 men and 633 305 women were included in our analysis. In men, the prevalence of any anaemia was 23·2% (95% CI 22·7–23·7), moderate or severe anaemia was 5·1% (4·9–5·4), and severe anaemia was 0·5% (0·5–0·6). An estimated 21·7% (20·9–22·5) of men with any degree of anaemia had moderate or severe anaemia compared with 53·2% (52·9–53·5) of women with any anaemia. Men aged 20–34 years had the lowest probability of having anaemia whereas anaemia prevalence among women was similar across age groups. State-level prevalence of any anaemia in men varied from 9·2% (7·7–10·9) in Manipur to 32·9% (31·0–34·7) in Bihar. The individual-level predictors of less household wealth, lower education, living in a rural area, smoking, consuming smokeless tobacco, and being underweight and the district-level predictors of living in a district with a lower rate of primary school completion, level of urbanisation, and household wealth were all associated with a higher probability of anaemia in men. Although some important exceptions were noted, district-level and state-level prevalence of anaemia among men correlated strongly with that among women. Interpretation: Anaemia among men in India is an important public health problem. Because of the similarities in the patterns of geographical and sociodemographic variation of anaemia between men and women, future efforts to reduce anaemia among men could target similar population groups as those targeted in existing efforts to reduce anaemia among women. Funding: Alexander von Humboldt Foundation.

Published
2019
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14. Analysis of Vegetable Nutritional Garden Interventions to Improve Socio-economic Status, Nutritional and Livelihood Security of Selected Beneficiaries under DST- WOS-B Project of District Moga, Punjab, India

Author

Ravi Deepika, Sonika Sharma, T. S. Dhillon, S. K. Jindal, and Manisha Dubey

Subjects
General Medicine
Abstract

Study was carried out in Punjab Agricultural University, Ludhiana, Punjab to analyse the impact of vegetable nutritional garden on the nutritional intake and socio- economic status of selected beneficiaries of District Moga, Punjab, India. Survey conducted to assess the impact of DST Project from 82 beneficiaries across the two blocks i.e. Village Khosapando and Niddhawala, Village Dagaru and Churchak from November- December, 2019 and again August-September, 2021, through a structured questionnaire developed by the Department of Food and Nutrition. The data pertaining to general profile, dietary habits, socio-economic status of the beneficiaries. The dietary diversity questionnaire include 12 groups of food like Cereals, Pulses, Green leafy vegetables, Roots, Tubers, Fruits, Vegetables, Milk and Milk products, Egg, Fat, Sugar, Meat and Miscellaneous. The information on respondent’s food consumption was collected using (24-hour recall).The results have shown that, there was difference in the nutritional uptake of beneficiaries during the intervention period and before the intervention of project. Under this project, area under vegetable cultivation has increased significantly in all selected villages over period 2019-2022 i.e. area under vegetable production in Village Khosa Pando, Dagru, Chuharchak and Nidhanwala increased by 91.6,100, 93.9, 94.2 percent. Moreover, per capita income of farmers having landholding of 0.5 to 1 acre and 0.1 to 0.5 acre has increased by 180 and 62 percent respectively. Furthermore, the consumption of green and leafy vegetables, roots and tubers, and other vegetables by intervention household increased drastically from 61.4, 48, 54 to 97.6, 95.0 and 88.1 respectively after establishing vegetable nutrition gardens.

Published
2022

18. Virtual environments to study emotional responses to clinical communication: A scoping review

Author

Ja-Nae Duane, Scott P. Orr, Danielle Blanch-Hartigan, William F. Pirl, James A. Tulsky, Jonathan D. Ericson, Emma Caponigro, Manisha Dubey, and Justin J. Sanders

Subjects
media_common.quotation_subject, Emotions, Applied psychology, Empathy, Virtual reality, computer.software_genre, Affect (psychology), External validity, 03 medical and health sciences, 0302 clinical medicine, Multidisciplinary approach, Humans, Leverage (statistics), 030212 general & internal medicine, media_common, Communication, 030503 health policy & services, Virtual Reality, General Medicine, Virtual machine, Arousal, 0305 other medical science, Psychology, computer, Inclusion (education)
Abstract

Objective This scoping review explores the potential for virtual environments (VE) to evaluate emotional outcomes in clinical communication research. Authors representing multiple disciplines use review results to propose potential research opportunities and considerations. Methods We utilized a structured framework for scoping reviews. We searched four literature databases for relevant articles. We applied multidisciplinary perspectives to synthesize relevant potential opportunities for emotion-focused communications research using VE. Results Twenty-one articles met inclusion criteria. They applied different methodological approaches, including a range of VE technologies and diverse emotional outcome measures, such as psychophysiological arousal, emotional valence, or empathy. Major research topics included use of virtual reality to provoke and measure emotional responses, train clinicians in communication skills, and increase clinician empathy. Conclusion Researchers may leverage VE technologies to ethically and systematically examine how characteristics of clinical interactions, environments, and communication impact emotional reactions and responses among patients and clinicians. Variability exists in how VE technologies are employed and reported in published literature, and this may limit the internal and external validity of the research. However, virtual reality can provide a low-cost, low-risk, experimentally controlled, and ecologically valid approach for studying clinician-patient communication. Practice implications Future research should leverage psychophysiological measures to further examine emotional responses during clinical communication scenarios and clearly report virtual environment characteristics to support evaluation of study conclusions, study replicability, and meta-analyses.

Published
2021

19. Physician empathy according to physicians: A multi-specialty qualitative analysis

Author

Rachel Schwartz, Judith A. Hall, Manisha Dubey, Justin J. Sanders, and Danielle Blanch-Hartigan

Subjects
Physician-Patient Relations, Psychotherapist, Communication, media_common.quotation_subject, Specialty, Empathy, General Medicine, Interpersonal communication, Burnout, Nonverbal communication, Patient satisfaction, Feeling, Orientation (mental), Physicians, Humans, Family Practice, Psychology, media_common
Abstract

Objectives To explore how physicians in neurology, family medicine, internal medicine, and emergency medicine characterize clinical empathy. Methods Physicians (N = 94) were asked to describe up to 10 examples of empathic physician behavior. Data were analyzed using template analysis. Results Physicians’ descriptions of clinical empathy patterned into three themes: Clinical Performance and Professionalism, Interpersonal Communication, and Clinician Orientation. Clinical Performance and Professionalism subthemes included physician competency and accessibility; intersection with institutional resources; and spending/making/taking time with patients. Interpersonal Communication subthemes involved information sharing; verbal and nonverbal approaches; interpersonal sensitivity; physician self-disclosure; and attention to emotion. Clinician Orientation encompassed general physician demeanor and internal thoughts and feelings that might be unobservable by patients. Physicians varied widely in the themes they mentioned in their definition of empathy. Conclusion Physicians hold diverse notions of clinical empathy. These extend beyond traditional affective and cognitive empathy definitions to include structural elements like team-based care and accessibility after hours. Communication behaviors were perceived as important for demonstrating empathy. Some physician descriptions of empathy may not be perceptible to patients. Practice Implications Training physicians to engage in behaviors that both they and patients perceive as empathic may lead to higher patient and physician satisfaction.

Published
2021

24. Optimal bidding strategy for price takers and customers in a competitive electricity market

Author

Somendra P.S. Mathur, Anoop Arya, and Manisha Dubey

Subjects
bidding strategy, competitive electricity market, rival’s behavior, genetic algorithm, Engineering (General). Civil engineering (General), TA1-2040
Abstract

Bidding strategies are highly associated with the profit maximization and decreasing the risks for power utilities in a competitive market. For finding the optimal bidding strategies price takers need appropriate bidding structure. Thus, it is required to consider the model as a bi-level optimization problem. In the lower level price takers submit bid strategically to the ISO and in the upper level maximization of social welfare performed by solving the ISO Market clearing price (MCP). This paper aim to summarize the price taker’s bidding strategy modeling methods for competitive market models on the state-of-the art. A new genetic algorithm approach in a day-ahead electricity market in sealed auction with a pay-as-bid MCP has been employed to solve the problem from two different viewpoints i.e. with symmetrical and unsymmetrical information. The efficiency of the proposed method has been tested on the IEEE-30 bus system.

Published
2017
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25. THE BUTTERFLY-PARTICLE SWARM OPTIMIZATION (BUTTERFLY-PSO/BF-PSO) TECHNIQUE AND ITS VARIABLES

Author

Ganga Agnihotri, Manisha Dubey, and Aashish Kumar Bohre

Subjects
Degree (graph theory), Computer science, Node (networking), MathematicsofComputing_NUMERICALANALYSIS, Particle swarm optimization, Butterfly-PSO (BF-PSO), Butterfly communication network, ComputerSystemsOrganization_PROCESSORARCHITECTURES, Star (graph theory), Probability of nectar, ComputingMethodologies_ARTIFICIALINTELLIGENCE, Intelligent Network, Sensitivity, Butterfly, Convergence (routing), Particle swarm optimization (PSO), Optimization techniques, Sensitivity (control systems), Optimization techniques, Butterfly-PSO (BF-PSO), Algorithm
Abstract

The new presented Butterfly-PSO technique (or BF-PSO) is basically originated by Particle Swarm Optimization (PSO). The Butterfly-PSO technique (BF-PSO) appears as a new growing star among all optimization techniques. The proposed ‘Butterfly- Particle Swarm Optimization (Butterfly or BF-PSO)’ is inspired by butterfly natural intelligence, character, behavior, intelligent network and intelligent communication during the nectar search process. The BF-PSO introduces new parameters such as sensitivity of butterfly (s), probability of food (nectar) (p), the degree of the node and the time varying probability coefficient (α). These parameters improve the searching ability, excellent convergence and the overall performance of the Butterfly-PSO effectivly. The BF-PSO optimizations results have been presented for various functions with the multi-dimension problems.

Published
2022
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32. Enhancement of electricity wheeling charges by incorporating FACTS controller in restructured power system

Author

Gaurav Gupta, Manisha Dubey, and Anoop Arya

Subjects
010302 applied physics, Cost allocation, Mains electricity, Computer science, 020206 networking & telecommunications, 02 engineering and technology, General Medicine, Transmission system, AC power, 01 natural sciences, Wheeling, Reliability engineering, Electric power system, Electric power transmission, 0103 physical sciences, 0202 electrical engineering, electronic engineering, information engineering, Electric power industry
Abstract

In the past few decades, the demand for electricity has increased substantially. A number of factors affect this rapid rise in electricity demand. With this increased demand the role of transmission network becomes crucial for suitable operation, especially under restructured environment. The different limitations such as stability limit, voltage limit and thermal limits enforce restrictions on power wheeling capability of transmission lines. The major issues associated with power industry especially in the pool-based market are the recovery of transmission costs apportioned between the diverse. Restructuring of the electricity supply industry has taken place around the world. This restructuring consists of various new aspects such as transmission embedded cost allocation, reactive power cost allocation, transmission loss allocation, the impact of power flow regulating devices etc. Many methodologies and algorithms were proposed for addressing these issues. In this paper, FACTS incorporated power flow model is used for the determination of flow of real and reactive power by using the power flow tracing principle, which involves matrix properties for the real and reactive power allocation and cost allocation for different participants. FACTS devices which have the capability of regulating the power flow and voltage support at the buses. Hence UPFC incorporated in the transmission system have been considered in this paper. Comparative results with and without FACT controller are present for the sample 5 bus system and methodology also tested on IEEE 14 bus system.

Published
2020

33. Optimal generator side bidding with carbon emission trading and risk management

Author

Anoop Arya, Somendra P. S. Mathur, and Manisha Dubey

Subjects
010302 applied physics, Computer science, business.industry, Market clearing, 020206 networking & telecommunications, Carbon emission trading, 02 engineering and technology, General Medicine, Bidding, Environmental economics, 01 natural sciences, Multi-objective optimization, Greenhouse gas, 0103 physical sciences, 0202 electrical engineering, electronic engineering, information engineering, Emissions trading, Emerging markets, business, Risk management
Abstract

Global warming is one of the most alarming phenomena facing our planet today. There is a consensus among scientists that human-induced greenhouse gases (GHGs) should be regulated to slow down the heating of the Earth’s oceans and atmosphere. Energy consumption and CO2 emissions are continuously increasing in different countries, especially developing ones such as India, whose emerging economy and rapid economic development has caught the attention of the world. CO2 emission trading is executed by the various developed countries to alleviate the affect of GHG emissions. In this work, an optimal bidding strategy for a supplier has been developed, considering rival’s bidding behavior, in an hourly day-ahead pool market. Bidding problem has been formulated as a bi-level multi objective optimization problem (BLMOOP), where in the first level generator submit bid strategically to the ISO and in the next level a particle swarm optimization (PSO) approach has been employed for the maximization of social welfare with risk management. It is assumed that each generator should submit bid in sealed auction based on pay-as-bid MCP (market clearing price) mechanism with knowing the rival’s bidding behavior. The practicability of proposed optimization method is examined by an IEEE-30 bus system which consists of six suppliers.

Published
2020

34. Quantifying risks and interventions that have affected the burden of lower respiratory infections among children younger than 5 years

Author

Tesfaye Dessale Kassa, Félix Carvalho, Luke D. Knibbs, Sonia Lewycka, Sonali Kochhar, Aaron Cohen, Luca Ronfani, Ebrahim M Yimer, Srinivas Murthy, Ejaz Ahmad Khan, Josip Car, Rodrigo Sarmiento-Suarez, Babak Moazen, Mostafa Qorbani, Javad Nazari, Nancy Fullman, Niranjan Kissoon, Keyghobad Ghadiri, Marissa B Reitsma, Benn Sartorius, Ashish Awasthi, Aman Yesuf Endries, Christopher Troeger, Evanson Z. Sambala, Nelson Alvis-Guzman, Alessandra C. Goulart, Erlyn Rachelle King Macarayan, Ahmad Daryani, Fakher Rahim, Fiseha Wadilo Wada, Yuming Guo, Sonia Saxena, Justin R. Ortiz, Monika Sawhney, Eyal Oren, Alaa Badawi, Tomislav Mestrovic, Sezer Kisa, Cheru Tesema Leshargie, Ai Koyanagi, Long Hoang Nguyen, Alireza Rafiei, Aziz Rezapour, Huong Lan Thi Nguyen, Abdallah M. Samy, Catrin E. Moore, André Karch, Seyyed Meysam Mousavi, Chi Linh Hoang, Katie R Nielsen, Eleonora Dubljanin, Giuseppe Gorini, Charles Shey Wiysonge, Bach Xuan Tran, Christopher J L Murray, Khanh Bao Tran, Maarten J. Postma, Mohammad Sadegh Rezai, Bartosz Miazgowski, Hagos Tasew Atalay, Aziz Sheikh, Reginald Quansah, Kirsten E. Wiens, Mika Shigematsu, Devasahayam J. Christopher, Hamid Yimam Hassen, Yasir Waheed, Robert Reiner, Smita Pakhale, Joseph Adel Mattar Banoub, Fares Alahdab, Vafa Rahimi-Movaghar, Mahesh P A, Ruth W Kimokoti, Feleke Mekonnen Demeke, Mohamad-Hani Temsah, Zakir Hussain, Naohiro Yonemoto, Noore Alam, Mu'awiyyah Babale Sufiyan, Lidia Morawska, Adane Teshome Kefale, Ali H. Mokdad, Rachel L Updike, Amir Kasaeian, Yousef Veisani, Rajesh Kumar Rai, Jeffrey D. Stanaway, Mina Anjomshoa, Corey B. Bills, Puja C Rao, Euripide Frinel G Arthur Avokpaho, Lorenzo Monasta, Zoubida Zaidi, Yousef Khader, Heather J. Zar, Ali Bijani, Tommi Vasankari, Kefyalew Addis Alene, Young-Ho Khang, Afewerki Gebremeskel Tsadik, Joseph Frostad, Ghulam Mustafa, Jalal Arabloo, Rajaa Al-Raddadi, Shanshan Li, David L. Smith, Maria Jesus Rios-Blancas, Carlos A Castañeda-Orjuela, Syed Mohamed Aljunid, Andrew T Olagunju, Suleman Atique, Abdullah T Khoja, Ibrahim A Khalil, William M. Gardner, Zikria Saleem, Addisu Melese, Stephen S Lim, Eyasu Ejeta Duken, Erkin M. Mirrakhimov, Gessessew Bugssa Hailu, Hmwe H Kyu, Seyedmojtaba Seyedmousavi, Aleksandra Barac, Spencer L. James, Salvatore Rubino, Lalit Dandona, Arya Haj-Mirzaian, Kate Causey, Nicholas J Kassebaum, Simon I. Hay, Ravi Prakash Jha, Karzan Abdulmuhsin Mohammad, Son Hoang Nguyen, Belay Tessema, Muhammad Imran Nisar, Barthelemy Kuate Defo, Alireza Ahmadi, Theo Vos, Krittika Bhattacharyya, Irfan Ullah, Molly H Biehl, Kalpana Balakrishnan, Tinuke O Olagunju, Florian Fischer, Olatunde Aremu, Brigette F. Blacker, Derrick A Bennett, Vahid Alipour, Carl Abelardo T. Antonio, Manisha Dubey, Tuomo J. Meretoja, G Anil Kumar, Varshil Mehta, Molly R Nixon, Eduarda Fernandes, Chandrashekhar T Sreeramareddy, Anselm Okoro, Zulfiqar A Bhutta, Maysaa El Sayed Zaki, Shafiu Mohammed, Nuruzzaman Khan, Jost B. Jonas, Samah Awad, Miloje Savic, Soewarta Kosen, Quique Bassat, Amha Admasie, Cuong Tat Nguyen, Chalachew Genet Akal, Milena M Santric Milicevic, Adnan Kisa, Arvin Haj-Mirzaian, Jonathan F. Mosser, Stephanie R M Zimsen, Dharmesh Kumar Lal, Birhanu Geta, Nobuyuki Horita, Gulfaraz Khan, Saeed Amini, Ziad A. Memish, Rakhi Dandona, Alyssa N. Sbarra, Dietrich Rothenbacher, Samer Hamidi, Felix Akpojene Ogbo, Helena Manguerra, Shirin Djalalinia, Degu Abate, Rakesh Lodha, Samuel B. Albertson, Seyed Sina Naghibi Irvani, Abdullah Al Mamun, Neeraj Bedi, Parvaiz A Koul, Desalegn Tadese Mengistu, Katie Welgan, Masood Ali Shaikh, Marek Majdan, Mihaela Hostiuc, Mohamed Lemine Cheikh brahim Ahmed, Public Health, GBD Lower Resp Infect, Microbes in Health and Disease (MHD), Real World Studies in PharmacoEpidemiology, -Genetics, -Economics and -Therapy (PEGET), Value, Affordability and Sustainability (VALUE), Collaborators, GBD 2017 Lower Respiratory Infections, Clinicum, Institute for Molecular Medicine Finland, HUS Comprehensive Cancer Center, Staff Services, University of Helsinki, II kirurgian klinikka, and Department of Oncology

Subjects
Male, Psychological intervention, Global Health, Global Burden of Disease, 0302 clinical medicine, Risk Factors, Case fatality rate, Medicine, 030212 general & internal medicine, Respiratory Tract Infections, INFLUENZAE TYPE-B, education.field_of_study, NUTRITION TRANSITION, CHALLENGES, Trastornos respiratorios, Incidence (epidemiology), Mortality rate, Incidence, Enfermedades en niños, CHILDHOOD PNEUMONIA, Children younger than 5 years, 3. Good health, Infectious Diseases, Child, Preschool, Child Mortality, Female, TERRITORIES, CONJUGATE VACCINE, 030231 tropical medicine, Population, 195 COUNTRIES, Infections, Article, CHINA, 03 medical and health sciences, Age Distribution, Nutrition transition, SYSTEMATIC ANALYSIS, Humans, Risk factor, education, Lower respiratory, Models, Statistical, business.industry, AIR-POLLUTION, Verbal autopsy, Enfermedades respiratorias, Socioeconomic Factors, 3121 General medicine, internal medicine and other clinical medicine, Human medicine, business, Demography
Abstract

Background Despite large reductions in under-5 lower respiratory infection (LRI) mortality in many locations, the pace of progress for LRIs has generally lagged behind that of other childhood infectious diseases. To better inform programmes and policies focused on preventing and treating LRIs, we assessed the contributions and patterns of risk factor attribution, intervention coverage, and sociodemographic development in 195 countries and territories by drawing from the Global Burden of Diseases, Injuries, and Risk Factors Study 2017 (GBD 2017) LRI estimates. Methods We used four strategies to model LRI burden: the mortality due to LRIs was modelled using vital registration data, demographic surveillance data, and verbal autopsy data in a predictive ensemble modelling tool; the incidence of LRIs was modelled using population representative surveys, health-care utilisation data, and scientific literature in a compartmental meta-regression tool; the attribution of risk factors for LRI mortality was modelled in a counterfactual framework; and trends in LRI mortality were analysed applying changes in exposure to risk factors over time. In GBD, infectious disease mortality, including that due to LRI, is among HIV-negative individuals. We categorised locations based on their burden in 1990 to make comparisons in the changing burden between 1990 and 2017 and evaluate the relative percent change in mortality rate, incidence, and risk factor exposure to explain differences in the health loss associated with LRIs among children younger than 5 years. Findings In 2017, LRIs caused 808 920 deaths (95% uncertainty interval 747 286–873 591) in children younger than 5 years. Since 1990, there has been a substantial decrease in the number of deaths (from 2 337 538 to 808 920 deaths; 65·4% decrease, 61·5–68·5) and in mortality rate (from 362·7 deaths [330·1–392·0] per 100 000 children to 118·9 deaths [109·8–128·3] per 100 000 children; 67·2% decrease, 63·5–70·1). LRI incidence declined globally (32·4% decrease, 27·2–37·5). The percent change in under-5 mortality rate and incidence has varied across locations. Among the risk factors assessed in this study, those responsible for the greatest decrease in under-5 LRI mortality between 1990 and 2017 were increased coverage of vaccination against Haemophilus influenza type b (11·4% decrease, 0·0–24·5), increased pneumococcal vaccine coverage (6·3% decrease, 6·1–6·3), and reductions in household air pollution (8·4%, 6·8–9·2). Interpretation Our findings show that there have been substantial but uneven declines in LRI mortality among countries between 1990 and 2017. Although improvements in indicators of sociodemographic development could explain some of these trends, changes in exposure to modifiable risk factors are related to the rates of decline in LRI mortality. No single intervention would universally accelerate reductions in health loss associated with LRIs in all settings, but emphasising the most dominant risk factors, particularly in countries with high case fatality, can contribute to the reduction of preventable deaths. Funding Bill & Melinda Gates Foundation.

Published
2020

35. Interest and Knowledge of HIV Pre-Exposure Prophylaxis in a Unified Jail and Prison Setting

Author

Jennifer G. Clarke, Nickolas Zaller, Madeline C. Montgomery, Meghan Peterson, Philip A. Chan, Rosemarie A. Martin, Lauren Brinkley-Rubinstein, Christina Crowley, and Manisha Dubey

Subjects
Adult, Male, Community and Home Care, Health Knowledge, Attitudes, Practice, medicine.medical_specialty, business.industry, Racial Groups, Public Health, Environmental and Occupational Health, Human immunodeficiency virus (HIV), HIV Infections, Middle Aged, Patient Acceptance of Health Care, medicine.disease_cause, United States, Prison setting, Pre-exposure prophylaxis, Prisons, Family medicine, medicine, Humans, Pre-Exposure Prophylaxis, Homosexuality, Male, Substance Abuse, Intravenous, business, Jails
Abstract

Pre-exposure prophylaxis (PrEP) may be an effective approach to prevent HIV among people who are currently incarcerated or who have been recently released from incarceration. However, awareness and interest in PrEP are largely unknown in this population. This study assessed 417 incarcerated men's lifetime HIV risk engagement and gauged their interest and willingness to take PrEP. Twenty percent reported ever injecting drugs and 4% ever having sex with a man without a condom; 88% had never heard of PrEP. More White men had heard of PrEP, but higher percentages of men of color were interested in learning more about PrEP and willing to take PrEP to prevent HIV. Future interventions should focus on PrEP education and uptake among individuals who are incarcerated.

Published
2020

36. Threshold Levels of Infant and Under-Five Mortality for Crossover between Life Expectancies at Ages Zero, One and Five in India: A Decomposition Analysis.

Author

Manisha Dubey, Usha Ram, and Faujdar Ram

Subjects
Medicine, Science
Abstract

OBJECTIVES:Under the prevailing conditions of imbalanced life table and historic gender discrimination in India, our study examines crossover between life expectancies at ages zero, one and five years for India and quantifies the relative share of infant and under-five mortality towards this crossover. METHODS:We estimate threshold levels of infant and under-five mortality required for crossover using age specific death rates during 1981-2009 for 16 Indian states by sex (comprising of India's 90% population in 2011). Kitagawa decomposition equations were used to analyse relative share of infant and under-five mortality towards crossover. FINDINGS:India experienced crossover between life expectancies at ages zero and five in 2004 for menand in 2009 for women; eleven and nine Indian states have experienced this crossover for men and women, respectively. Men usually experienced crossover four years earlier than the women. Improvements in mortality below ages five have mostly contributed towards this crossover. Life expectancy at age one exceeds that at age zero for both men and women in India except for Kerala (the only state to experience this crossover in 2000 for men and 1999 for women). CONCLUSIONS:For India, using life expectancy at age zero and under-five mortality rate together may be more meaningful to measure overall health of its people until the crossover. Delayed crossover for women, despite higher life expectancy at birth than for men reiterates that Indian women are still disadvantaged and hence use of life expectancies at ages zero, one and five become important for India. Greater programmatic efforts to control leading causes of death during the first month and 1-59 months in high child mortality areas can help India to attain this crossover early.

Published
2015
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37. Global, regional, and national burden of brain and other CNS cancer, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016

Author

Molly R Nixon, Saeid Safiri, Ahmad Daryani, Mostafa Qorbani, Nahla Anber, Tahiya Alam, Amir Kasaeian, Nima Hafezi-Nejad, Félix Carvalho, Yun Jin Kim, Khanh Bao Tran, Gebre Teklemariam Demoz, Ejaz Ahmad Khan, Bach Xuan Tran, Irina Filip, Richard G. Ellenbogen, Mari Smith, Reza Shirkoohi, Sara Sheikhbahaei, Ibrahim A Khalil, Emma Nichols, Ebrahim M Yimer, Zoubida Zaidi, Ahmed Abdelalim, Ashish Awasthi, Mehdi Sharif, Foad Abd-Allah, Karzan Abdulmuhsin Mohammad, Christina Fitzmaurice, Eduarda Fernandes, Abdallah M. Samy, Shahabeddin Sarvi, Gabriel David Pinilla-Monsalve, Mihajlo Jakovljevic, Hosein Safari, Elisabete Weiderpass, Jee-Young Jasmine Choi, Huyen Phuc Do, Fares Alahdab, Gabriele Nagel, Gurudatta Naik, James D. Harvey, Hossein Poustchi, Simon I. Hay, Rajesh Sharma, Mohsen Naghavi, Huong Lan Thi Nguyen, Hamid Yimam Hassen, Abadi Kahsu Gebre, Andrew T Olagunju, Ali H. Mokdad, Masood Ali Shaikh, Dominic Agius, Christine A. Allen, Abate Bekele Belachew, Seyed Sina Naghibi Irvani, Anoop P. Patel, Ravi Prakash Jha, Ali Bijani, Samer Hamidi, Jasvinder A. Singh, Kidu Gidey Weldegwergs, David M. Pereira, Theo Vos, Haftom Niguse Abraha, Yilma Chisha Dea Geramo, Kyle J Foreman, Meaza Girma Degefa, Irfan Ullah, Valery L. Feigin, James L. Fisher, Gholamreza Roshandel, Young-Ho Khang, Ferrán Catalá-López, Rafael Tabarés-Seisdedos, Long Hoang Nguyen, Amir Radfar, Christopher J L Murray, Jemal Abdela, Robert Reiner, Vesna Zadnik, Manisha Dubey, Getnet Mengistu, Hamid Badali, Trang Huyen Nguyen, Tone Bjørge, Bill & Melinda Gates Foundation, and GBD 2016 Brain CNS Canc

Subjects
Adult, Male, Burden of disease, medicine.medical_specialty, Adolescent, Total fertility rate, CNS cancer, Global Burden of Disease, Central Nervous System Neoplasms, Young Adult, 03 medical and health sciences, Sex Factors, 0302 clinical medicine, Cost of Illness, Risk Factors, Epidemiology, Prevalence, Humans, Medicine, Child, Aged, Aged, 80 and over, Estimation, Brain Neoplasms, business.industry, Incidence, Incidence (epidemiology), Age Factors, 1. No poverty, Infant, Middle Aged, 3. Good health, Cancer registry, Fertility, Years of potential life lost, Socioeconomic Factors, Child, Preschool, 030220 oncology & carcinogenesis, Female, Human medicine, Neurology (clinical), business, 030217 neurology & neurosurgery, Demography
Abstract

BACKGROUND: Brain and CNS cancers (collectively referred to as CNS cancers) are a source of mortality and morbidity for which diagnosis and treatment require extensive resource allocation and sophisticated diagnostic and therapeutic technology. Previous epidemiological studies are limited to specific geographical regions or time periods, making them difficult to compare on a global scale. In this analysis, we aimed to provide a comparable and comprehensive estimation of the global burden of brain cancer between 1990 and 2016. METHODS: We report means and 95% uncertainty intervals (UIs) for incidence, mortality, and disability-adjusted life-years (DALYs) estimates for CNS cancers (according to the International Classification of Diseases tenth revision: malignant neoplasm of meninges, malignant neoplasm of brain, and malignant neoplasm of spinal cord, cranial nerves, and other parts of CNS) from the Global Burden of Diseases, Injuries, and Risk Factors Study 2016. Data sources include vital registration and cancer registry data. Mortality was modelled using an ensemble model approach. Incidence was estimated by dividing the final mortality estimates by mortality to incidence ratios. DALYs were estimated by summing years of life lost and years lived with disability. Locations were grouped into quintiles based on the Socio-demographic Index (SDI), a summary indicator of income per capita, years of schooling, and total fertility rate. FINDINGS: In 2016, there were 330 000 (95% UI 299 000 to 349 000) incident cases of CNS cancer and 227 000 (205 000 to 241 000) deaths globally, and age-standardised incidence rates of CNS cancer increased globally by 17·3% (95% UI 11·4 to 26·9) between 1990 and 2016 (2016 age-standardised incidence rate 4·63 per 100 000 person-years [4·17 to 4·90]). The highest age-standardised incidence rate was in the highest quintile of SDI (6·91 [5·71 to 7·53]). Age-standardised incidence rates increased with each SDI quintile. East Asia was the region with the most incident cases of CNS cancer for both sexes in 2016 (108 000 [95% UI 98 000 to 122 000]), followed by western Europe (49 000 [37 000 to 54 000]), and south Asia (31 000 [29 000 to 37 000]). The top three countries with the highest number of incident cases were China, the USA, and India. CNS cancer was responsible for 7·7 million (95% UI 6·9 to 8·3) DALYs globally, a non-significant change in age-standardised DALY rate of -10·0% (-16·4 to 2·6) between 1990 and 2016. The age-standardised DALY rate decreased in the high SDI quintile (-10·0% [-27·1 to -0·1]) and high-middle SDI quintile (-10·5% [-18·4 to -1·4]) over time but increased in the low SDI quintile (22·5% [11·2 to 50·5]). INTERPRETATION: CNS cancer is responsible for substantial morbidity and mortality worldwide, and incidence increased between 1990 and 2016. Significant geographical and regional variation in the incidence of CNS cancer might be reflective of differences in diagnoses and reporting practices or unknown environmental and genetic risk factors. Future efforts are needed to analyse CNS cancer burden by subtype. FUNDING: Bill & Melinda Gates Foundation. Bill & Melinda Gates Foundation Sí

Published
2019

38. Impact of COVID-19 infection on life expectancy, premature mortality, and DALY in Maharashtra, India

Author

Udaya S. Mishra, Guru Vasishtha, Umakanta Sahoo, Manisha Dubey, and Sanjay K. Mohanty

Subjects
Adult, Male, medicine.medical_specialty, Coronavirus disease 2019 (COVID-19), Adolescent, Premature mortality, Life expectancy, Population, India, Infectious and parasitic diseases, RC109-216, 01 natural sciences, 03 medical and health sciences, Young Adult, 0302 clinical medicine, Epidemiology, Medicine, Humans, 030212 general & internal medicine, 0101 mathematics, Young adult, YPLL, education, Child, Aged, Expectancy theory, Aged, 80 and over, education.field_of_study, DALY, business.industry, Mortality, Premature, 010102 general mathematics, Infant, Newborn, COVID-19, Infant, Middle Aged, Maharashtra, Quality-adjusted life year, Infectious Diseases, Years of potential life lost, Child, Preschool, Female, Quality-Adjusted Life Years, business, Demography, Research Article
Abstract

Background The COVID-19 infections and deaths have largely been uneven within and between countries. With 17% of the world’s population, India has so far had 13% of global COVID-19 infections and 8.5% of deaths. Maharashtra accounting for 9% of India’s population, is the worst affected state, with 19% of infections and 33% of total deaths in the country until 23rd December 2020. Though a number of studies have examined the vulnerability to and spread of COVID-19 and its effect on mortality, no attempt has been made to understand its impact on mortality in the states of India. Method Using data from multiple sources and under the assumption that COVID-19 deaths are additional deaths in the population, this paper examined the impact of the disease on premature mortality, loss of life expectancy, years of potential life lost (YPLL), and disability-adjusted life years (DALY) in Maharashtra. Descriptive statistics, a set of abridged life tables, YPLL, and DALY were used in the analysis. Estimates of mortality indices were compared pre- and during COVID-19. Result COVID-19 attributable deaths account for 5.3% of total deaths in the state and have reduced the life expectancy at birth by 0.8 years, from 73.2 years in the pre-COVID-19 period to 72.4 years by the end of 2020. If COVID-19 attributable deaths increase to 10% of total deaths, life expectancy at birth will likely reduce by 1.4 years. The probability of death in 20–64 years of age (the prime working-age group) has increased from 0.15 to 0.16 due to COVID-19. There has been 1.06 million additional loss of years (YPLL) in the state, and DALY due to COVID-19 has been estimated to be 6 per thousand. Conclusion COVID-19 has increased premature mortality, YPLL, and DALY and has reduced life expectancy at every age in Maharashtra.

Published
2021

39. Delving into Ponzi Schemes - Evolution Impact and Enforcement

Author

Visakha Raghuram and Manisha Dubey

Subjects
Market economy, business.industry, Ponzi scheme, Business, Root cause, Investment (macroeconomics), Enforcement, Financial services, Simple (philosophy)
Abstract

Ponzi Schemes is not a very complex form of thievery, in fact, they are quite simple. The only job is to dupe the unassuming investors into handing over their money under the guise that it would be placed into some form of investment. Given that it’s a scam, the money is never really invested, yet the “returns” do in turn happen. The question as to how the swindler manages to return the investment is answered in this paper. Furthermore, mushrooming of the Ponzi scheme in India is a common occurrence in the contemporary times, the root cause for such scams could be found in the failure of the formal financial institutions in catering to the felt needs of the people for a savings and thrift schemes by expanding their geographical coverage to all parts of India and a general lack of awareness amongst masses of the distinction between legal and permitted financial products and illegal and unsafe schemes. The article further analyses various Indian cases and assesses the viability of the Laws in force in India and the newly introduced the Unregulated Deposits Schemes (Banning) Act, 2019 and the Unregulated Deposits Schemes Rules, 2020.

Published
2021

40. HAP-SAP: Semantic Annotation in LBSNs using Latent Spatio-Temporal Hawkes Process

Author

P. K. Srijith, Manisha Dubey, and Maunendra Sankar Desarkar

Subjects
Social and Information Networks (cs.SI), FOS: Computer and information sciences, Multivariate statistics, Semantic annotation, Process (engineering), business.industry, Computer science, Computer Science - Social and Information Networks, Machine learning, computer.software_genre, Spatial mobility, Artificial intelligence, business, computer
Abstract

The prevalence of location-based social networks (LBSNs) has eased the understanding of human mobility patterns. Knowledge of human dynamics can aid in various ways like urban planning, managing traffic congestion, personalized recommendation etc. These dynamics are influenced by factors like social impact, periodicity in mobility, spatial proximity, influence among users and semantic categories etc., which makes location modelling a critical task. However, categories which act as semantic characterization of the location, might be missing for some check-ins and can adversely affect modelling the mobility dynamics of users. At the same time, mobility patterns provide a cue on the missing semantic category. In this paper, we simultaneously address the problem of semantic annotation of locations and location adoption dynamics of users. We propose our model HAP-SAP, a latent spatio-temporal multivariate Hawkes process, which considers latent semantic category influences, and temporal and spatial mobility patterns of users. The model parameters and latent semantic categories are inferred using expectation-maximization algorithm, which uses Gibbs sampling to obtain posterior distribution over latent semantic categories. The inferred semantic categories can supplement our model on predicting the next check-in events by users. Our experiments on real datasets demonstrate the effectiveness of the proposed model for the semantic annotation and location adoption modelling tasks., 11 pages

Published
2020

41. Impact of COVID-19 Attributable Deaths on Longevity, Premature Mortality and DALY: Estimates of USA, Italy, Sweden and Germany

Author

Manisha Dubey, Udaya S. Mishra, Umakanta Sahoo, and Sanjay K. Mohanty

Subjects
Years of potential life lost, Coronavirus disease 2019 (COVID-19), business.industry, media_common.quotation_subject, Population projection, Pandemic, Life expectancy, Longevity, Medicine, business, Disease control, media_common, Demography
Abstract

In a short span of four months, the COVID-19 pandemic has added over 0.4 million deaths worldwide, which are untimely, premature and unwarranted. The USA, Italy, Germany and Sweden are four worst affected countries, accounting to over 40% of COVID-19 deaths globally. The main objective of this study is to examine the impact of COVID-19 attributable deaths on longevity, years of potential life lost (YPLL) and disability adjusted life years (DALY) in USA, Italy, Germany and Sweden. Data from United Nation Population Projection, Statista and centre for disease control and prevention were used in the analyses. Life expectancy, YPLL and DALY were estimated under four scenarios; no COVID-19 deaths, actual number of COVID-19 death as of 22ndMay, 2020 and anticipating COVID-19 death share of 6% and 10% respectively. The COVID-19 attributable deaths have lowered the life expectancy by 0.4 years each in USA and Sweden, 0.5 years in Italy and 0.1 years in Germany. The loss of YPLL was 1.5, 0.5, 0.1 and 0.5 million in USA, Italy, Germany and Sweden respectively. The DALY (per 1000 population) due to COVID-19 was 4 in USA, 6 in Italy, 1 each in Germany and Sweden. Compression in life expectancy and increase in YPLL and DALY may intensify further if death continues to soar. COVID-19 has a marked impact on mortality. Reduction in longevity premature mortality and loss of DALY is higher among elderly.

Published
2020
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42. What is clinical empathy? Perspectives of community members, university students, cancer patients, and physicians

Author

Rachel Schwartz, Judith A. Hall, Justin J. Sanders, David DeSteno, Yuan Niu, Fred Duong, and Manisha Dubey

Subjects
Universities, media_common.quotation_subject, Empathy, 03 medical and health sciences, 0302 clinical medicine, Group differences, Emotionality, Perception, Neoplasms, Physicians, Humans, Active listening, 030212 general & internal medicine, Students, media_common, Physician-Patient Relations, 030503 health policy & services, Communication, Stakeholder, General Medicine, Feeling, Oncology patients, 0305 other medical science, Psychology, Clinical psychology
Abstract

Objectives To explore what undergraduates, community members, oncology patients, and physicians consider empathic behavior in a physician. Methods 150 undergraduates, 152 community members, 95 physicians, and 89 oncology patients rated 49 hypothetical physician behaviors for how well they fit their personal definition of physician empathy. Dimensions of empathy were explored and compared across groups. Results Three dimensions of empathy were Conscientious and Reassuring, Relationship Oriented, and Emotionally Involved. Relationship Oriented was the most strongly endorsed, followed by Emotionally Involved, with Conscientious and Reassuring coming in last. There were no group differences for Conscientious and Reassuring, but the Relationship Oriented factor was more endorsed by the clinical groups (physicians and patients) than the non-clinical groups. The Emotionally Involved factor was endorsed by physicians notably more than by patients. Conclusion What is considered clinical empathy is not the same across individuals and stakeholder groups. Practice Implications Physicians and patients differ in how much they include the physicians’ emotionality and emotion-related actions in their definition of empathy. Communication training for physicians that emphasizes behaviors associated with empathy (listening, understanding a person’s feelings and perspectives, and showing interest in and concern for the whole person) may enhance patients’ perception of clinical empathy.

Published
2020

43. Age Pattern of Premature Mortality under varying scenarios of COVID-19 Infection in India

Author

Udaya S. Mishra, Manisha Dubey, Umakanta Sahoo, and Sanjay K. Mohanty

Subjects
education.field_of_study, Descriptive statistics, business.industry, Mortality rate, Population, Years of potential life lost, Case fatality rate, Pandemic, Life expectancy, Medicine, business, education, Developed country, Demography
Abstract

BackgroundIndia is vulnerable to community infection of COVID-19 due to crowded and poor living condition, high density, slums in urban areas and poor health care system. The number of COVID 19 infection has crossed 300,000 with over 7,500 deaths despite a prolonged period of lock down and restrictions in public spaces. Given the likely scale and magnitude of this pandemic, it is important to understand its impact on the age pattern of mortality under varying scenarios.ObjectiveThe main objective of this paper is to understand the age pattern of mortality under varying scenarios of community infection.Data and MethodsData from the Sample Registration System (SRS), covidi19india.org and country specific data from worldmeter is used in the analyses. Descriptive statistics, case-fatality ratio, case fatality ratio with 14 days delay, abridged life table,years of potential life lost (YPLL) and disability adjusted life years (DALY) is used.ResultsThe case fatality ratio (CFR) with 14 days delay for India is at least twice higher (8.0) than CFR of 3.4. Considering 8% mortality rate and varying scenario of community infection by 0.5%, 1% and 2%, India’s life expectancy will reduce by 0.8, 1.5 and 3.0 years and potential life years lost by 12.1 million, 24.3 million and 48.6 million years respectively. A community infection of 0.5% may result in DALY by 6.2 per 1000 population. Major share of PYLL and DALY is accounted by the working ages.ConclusionCOVID-19 has a visible impact on mortality with loss of productive life years in working ages. Sustained effort at containing the transmission at each administrative unit is recommended to arrest mortality owing to COVID-19 pandemic.What is known?The case fatality rate associated with COVID-19 is low in India compared to many other countries. The mortality level is higher among elderly and people with co-morbidity.ContributionThe case fatality ratio is illusive in the sense that the same with 14 days delay for India is at least twice higher (8.0). The COVID-19 attributable mortality has the potential to reduce the longevity of the population. Unlike developed countries, about half of the COVID-19 attributable mortality would be in the working age group of 45-64 years. With any level of community infection, the years of potential life lost (YPLL) and disability adjusted life years (DALY) world be highest in the working age group (45-64 years).

Published
2020
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44. Mapping geographical inequalities in childhood diarrhoeal morbidity and mortality in low-income and middle-income countries, 2000-17: analysis for the Global Burden of Disease Study 2017

Author

Manisha Dubey, Fatemeh Rajati, Mehran Shams-Beyranvand, Amir Khater, Reza Shirkoohi, Segun Emmanuel Ibitoye, David C. Schwebel, Milena Ilic, Kebede Embaye Gezae, Ali Akbar Fazaeli, Ronny Westerman, Taye Abuhay Zewale, Ravi Mehrotra, Sezer Kisa, Junaid Khan, Jost B. Jonas, Dian Kusuma, Marcel Ausloos, Getnet Gedefaw, Hamed Zandian, Edward J Mills, Aparna Lal, Atalay Goshu Muluneh, Leeberk Raja Inbaraj, Edgar Denova-Gutiérrez, Jacqueline Elizabeth Alcalde Rabanal, Yousef Veisani, Sharath Burugina Nagaraja, Christopher Troeger, Ismael R. Campos-Nonato, Kidane Tadesse Gebremariam, Maysaa El Sayed Zaki, Oliver J. Brady, David Laith Rawaf, Tamer H. Farag, Simin Mouodi, Hafiz Ansar Rasul Suleria, Saleh Salehi Zahabi, Soumyadeep Bhaumik, Samad Azari, Getinet Ayano, Faris Lami, Raaj Kishore Biswas, Maryam Adabi, Alaa Badawi, Saravanan Muthupandian, Amir Hasanzadeh, Martin Amogre Ayanore, Maziar Moradi-Lakeh, Mohamad-Hani Temsah, Kavumpurathu Raman Thankappan, Bineyam Taye, Nader Jafari Balalami, Hamid Yimam Hassen, Karzan Abdulmuhsin Mohammad, Paul H. Lee, Emerito Jose A. Faraon, Kewal Krishan, Muhammad Ali, Ehsan Sadeghi, Richard C. Franklin, Dara K. Mohammad, Naznin Hossain, Lal B. Rawal, Alyssa N. Sbarra, Behnam Heidari, Dietrich Rothenbacher, Hagos Tasew Atalay, Eric L. Ding, Noushin Mohammadifard, Nihal Thomas, Man Mohan Mehndiratta, Sanghamitra Pati, Addisu Melese, Niranjan Kissoon, Farzad Manafi, Carl Abelardo T. Antonio, Morteza Abdullatif Khafaie, Meysam Behzadifar, Mohammad Reza Sobhiyeh, Frank B. Osei, Koku Sisay Tamirat, Yahya Salimi, Pranab Chatterjee, Gebreamlak Gebremedhn Gebremeskel, Olatunji O. Adetokunboh, Benjamin K. Mayala, Bhaskaran Unnikrishnan, Zahid A Butt, Olufemi Ajumobi, Fiseha Wadilo Wada, Shafiu Mohammed, Charles Shey Shey Wiysonge, Félix Carvalho, Masresha Tessema Anegago, Yun Jin Kim, Ai-Min Wu, Ketema Bizuwork Gebremedhin, Paulina A. Lindstedt, Ana-Laura Manda, Aziz Eftekhari, Rakhi Dandona, Mehdi Fazlzadeh, Nicole Davis Weaver, Muluken Bekele Sorrie, Marwa Rashad Salem, Kassawmar Angaw Bogale, Dongyu Zhang, Saeed Safari, Vivekanand Jha, Keivan Ahmadi, Turki Alanzi, Amir Jalali, Hamidreza Haririan, Chukwudi A Nnaji, Kebadnew Mulatu Mihretie, Lucas Guimarães Abreu, Gessessew Bugssa Hailu, Surendra Karki, Kirsten E. Wiens, Boikhutso Tlou, Soraya Siabani, Muluken Azage Yenesew, Asnakew Achaw Ayele, Ayalew Jejaw Zeleke, Osayomwanbo Osarenotor, Susanna Dunachie, Marcos Roberto Tovani-Palone, Daniel Bekele Ketema, Tissa Wijeratne, Dessalegn Ajema Berbada, André Karch, Ebrahim Babaee, Akram Pourshams, Seyyed Meysam Mousavi, Bal Govind Chauhan, Giuseppe Remuzzi, Vera Marisa Costa, Mehdi Yaseri, Tahereh Pashaei, Benn Sartorius, Helen Derara Diro, Anelisa Jaca, Mostafa Hosseini, Nikolay Ivanovich Briko, Franz Castro, Cuong Tat Nguyen, Chalachew Genet Akal, Natalie Maria Cormier, Ghulam Mustafa, Sonia Lewycka, Achala Upendra Jayatilleke, David L. Smith, Ibrahim A Khalil, Genet Melak Alamene, George C Patton, Andem Effiong, Gebrekiros Gebremichael Meles, Collins Chansa, Tsegaye Lolaso Lenjebo, Van C. Lansingh, Chabila C Mapoma, Olayinka Stephen Ilesanmi, Aso Mohammad Darwesh, Aubrey J. Levine, Miliva Mozaffor, Till Bärnighausen, Ali Rostami, André Faro, Rushdia Ahmed, Colm McAlinden, Duduzile Ndwandwe, Neeraj Bedi, Irfan Ullah, Winfried März, Rajeev Gupta, Masood Ali Shaikh, Catalina Liliana Andrei, Ali Kazemi Karyani, Shaimaa I. El-Jaafary, Abbas Mosapour, Javad Nazari, Obinna Onwujekwe, Narinder Pal Singh, Dabere Nigatu, Tanuj Kanchan, Jagdish Khubchandani, Aklilu Endalamfaw, Hajer Elkout, Michelle L. Bell, Beyene Meressa Adhena, Evanson Z. Sambala, Nelson Alvis-Guzman, Nefsu Awoke, Mohammad Ali Sahraian, Muki Shey, Christiane Dolecek, Kedir Hussein Abegaz, Syed Ather Hussain, Birhan Tamene Alemnew, Arash Etemadi, Anwar E. Ahmed, Vinay Nangia, Sachin R Atre, Roghiyeh Faridnia, Robert C. Reiner, Rajat Das Gupta, Aniruddha Deshpande, Sanjay Zodpey, Birhanu Geta, Amaha Kahsay, Muktar Beshir Ahmed, Kiana Ramezanzadeh, Jacek Jerzy Jozwiak, Chi Linh Hoang, Bahram Armoon, Manfred Accrombessi, Christopher J L Murray, Ebrahim M Yimer, Rashmi Gupta, Ahmed Omar Bali, Dadi Marami, Arash Tehrani-Banihashemi, Getnet Mengistu, Govinda Prasad Dhungana, Fereshteh Ansari, Dina Nur Anggraini Ningrum, Mu'awiyyah Babale Sufiyan, Harish Chander Gugnani, Ali S. Akanda, Satar Rezaei, Wondimeneh Shibabaw Shiferaw, Irina Filip, Mohammad Fareed, Hagos Degefa Hidru, Morteza Shamsizadeh, Mojtaba Hoseini-Ghahfarokhi, Yared A Asmare Aynalem, Gelin Xu, Zubair Kabir, Khalid A Altirkawi, Beatriz Paulina Ayala Quintanilla, Kenean Getaneh Tlaye, Devasahayam J. Christopher, Malede Mequanent Sisay, Yibeltal Alemu Bekele, Mika Shigematsu, Bryan L. Sykes, Quique Bassat, Jemal Abdu Mohammed, Seyed Mostafa Mir, Moslem Soofi, Nuruzzaman Khan, Ensiyeh Jenabi, Seyed-Mohammad Fereshtehnejad, Alireza Esteghamati, Paramjit Gill, Nathaniel J Henry, Meghnath Dhimal, Hosein Shabaninejad, Trang Huyen Nguyen, Amjad Mohamadi-Bolbanabad, Eugenio Traini, Mohammad Zamani, Arianna Maever L. Amit, Mehran Alijanzadeh, Florian Fischer, Rafael Moreira Claro, Pushpendra Kumar, Shai Linn, Lucas Earl, Haileab Fekadu Wolde, Getenet Dessie, Doris D. V. Ortega-Altamirano, John S. Ji, Moritz U. G. Kraemer, Saeed Amini, Ziad A. Memish, Aisha Elsharkawy, Ken Lee Chin, Mustafa Z. Younis, Daniel Diaz, Hebat Allah Salah A. Yousof, Seifadin Ahmed Shallo, Tomohide Yamada, Adrian Pana, Salman Rawaf, Amir Almasi-Hashiani, Platon D. Lopukhov, Alireza Rafiei, Dragos Virgil Davitoiu, Hossein Poustchi, Ayele Geleto Bali, Francesco Saverio Violante, Leonardo Roever, Giovanni Damiani, Maha El Tantawi, Nuworza Kugbey, Hadi Pourjafar, Michael R.M. Abrigo, Dinh-Toi Chu, Farkhonde Salehi, Phetole Walter Mahasha, Farnam Mohebi, Sathish Thirunavukkarasu, Dharmesh Kumar Lal, Senbagam Duraisamy, Demelash Woldeyohannes Handiso, Eleonora Dubljanin, Takeshi Fukumoto, Biruck Desalegn Yirsaw, Fakher Rahim, Jasvinder A. Singh, Jai K Das, Savita Lasrado, Ana Isabel Ribeiro, Santosh Varughese, Adnan Kisa, Laurie B. Marczak, Amira Shaheen, Peter Njenga Keiyoro, Nader Jahanmehr, Yuming Guo, Arash Ziapour, Alex Yeshaneh, Ninuk Hariyani, Seyed Sina Naghibi Irvani, Sameer Vali Gopalani, Joel M. Francis, Asmamaw Demis, Ahamarshan Jayaraman Nagarajan, Praveen Hoogar, Nicola Luigi Bragazzi, Yunquan Zhang, Yousef Mohammad, Iman El Sayed, Vafa Rahimi-Movaghar, Anbissa Muleta Senbeta, Subramanian Senthilkumaran, Marzieh Nojomi, Tewodros Eshete Wonde, Sameh Magdeldin, Anton Sokhan, Nauman Khalid, Nima Hafezi-Nejad, Ben Lacey, Luca Ronfani, James Albright, Senthilkumar Balakrishnan, Ejaz Ahmad Khan, Khanh Bao Tran, Guoqing Hu, Yousef Khader, Parvaneh Mirabi, Boris Bikbov, Feleke Mekonnen Demeke, Assefa Desalew, Yasir Waheed, Berhe Etsay Tesfay, Julio Cesar Campuzano Rincon, Ernoiz Antriyandarti, Brian J. Hall, James A Platts-Mills, Gbenga A. Kayode, Jan-Walter De Neve, Maria Jesus Rios-Blancas, Navid Manafi, Ravi Prakash Jha, Yilma Chisha Dea Geramo, Hamideh Salimzadeh, Fisaha Haile Tesfay, Abdullah Al Mamun, Ali Bijani, Hedley Quintana, Shanshan Li, Kebreab Paulos, Joan B. Soriano, Victor Adekanmbi, Oladimeji Adebayo, David Teye Doku, Brijesh Sathian, Bakhtiar Piroozi, MohammadBagher Shamsi, Netsanet Fentahun, Shymaa Enany, Ayman Grada, Salvatore Rubino, Kenji Shibuya, Norberto Perico, Sergio I. Prada, Andrea Farioli, Gebremicheal Gebreslassie Kasahun, Mohsen Afarideh, Maciej Banach, Andrey Nikolaevich Briko, Mohsen Asadi-Lari, Rakesh Lodha, David M. Pigott, Bárbara Niegia Garcia de Goulart, Hadi Hassankhani, Daniel Adane Endalew, Siamak Sabour, Yoshan Moodley, Preeti Dhillon, Dilaram Acharya, Anas M. Saad, Ibrahim Abdelmageed Ginawi, Theo Vos, Tuomo J. Meretoja, Ireneous N. Soyiri, Hasan Yusefzadeh, Mohammad Rabiee, Ajay Patle, Rahman Shiri, Girmay Teklay Weldesamuel, Sivan Yegnanarayana Iyer Saraswathy, Mekdes Tigistu Yilma, Davide Guido, Chuanhua Yu, Abdallah M. Samy, Ali Talha Khalil, Ashish Awasthi, Pascual R. Valdez, Nelson G.M. Gomes, Nejimu Biza Zepro, Taweewat Wiangkham, Anthony Masaka, Afsaneh Arzani, Ayesha Humayun, Michael Tamene Haile, Huyen Phuc Do, Krittika Bhattacharyya, Maryam Khayamzadeh, Seth Christopher Yaw Appiah, Mehdi Ahmadi, Farah Daoud, QuynhAnh P Nguyen, Suleman Atique, Sheikh Mohammed Shariful Islam, Indang Trihandini, Mario Poljak, Bartosz Miazgowski, Huda Basaleem, Rafael Alves Guimares, Mina Anjomshoa, Peng Jia, Yafeng Wang, Erkin M. Mirrakhimov, Seyed Hossein Yahyazadeh Jabbari, Itamar S. Santos, Alireza Khatony, Desalegn Tadese Mengistu, Samath D Dharmaratne, S. Mohammad Sajadi, Francisco Rogerlândio Martins-Melo, Shankar M Bakkannavar, Konrad Pesudovs, Tina Beyranvand, Liliana Preotescu, Leticia Avila-Burgos, Enrico Rubagotti, Amira Hamed Darwish, Mahdi Safdarian, Ali Yadollahpour, Vijay Kumar Chattu, Moses K. Muriithi, Azmeraw T. Amare, Si Si, Joshua Longbottom, Somayeh Bohlouli, Khaled Khatab, Masoud Behzadifar, Anusha Ganapati Bhat, G Anil Kumar, Margaret Kosek, Mona M. Khater, Reta Tsegaye Gayesa, Ghobad Moradi, Srinivas Goli, Ruth W Kimokoti, Jalal Arabloo, Kimberly B. Johnson, Andrew T Olagunju, Mowafa Househ, In-Hwan Oh, Arya Haj-Mirzaian, Desta Haftu Hayelom, Jae Il Shin, Ahmed Abdelalim, Catherine A. Welgan, Veincent Christian Filipino Pepito, Andre Rodrigues Duraes, Yuan-Pang Wang, Rosario Cárdenas, Mohammad Khazaei, Sebastian Vollmer, Xiu-Ju Zhao, Mihajlo Jakovljevic, Degu Abate, Ali S. Shalash, Davide Rasella, Melese Abate Reta, Hedayat Abbastabar, Manu Raj Mathur, Aliasghar Ahmad Kiadaliri, Ritesh G. Menezes, Molly K. Miller-Petrie, Beriwan Abdulqadir Ali, Ahmed I. Hasaballah, Joseph Frostad, Eirini Skiadaresi, Aleksandra Barac, Simon I. Hay, Deborah Carvalho Malta, Brigette F. Blacker, Carlo La Vecchia, Eduarda Fernandes, Chandrashekhar T Sreeramareddy, Zewdie Aderaw Alemu, Foad Abd-Allah, Elias Merdassa Roro, Agus Sudaryanto, Fariba Ghassemi, Behzad Karami Matin, Mohsen Naghavi, Maarten J. Postma, Chhabi Lal Ranabhat, Maheswar Satpathy, Mahesh P A, Carlos Miguel Rios González, Pallab K. Maulik, Amir Kasaeian, Ali H. Mokdad, Alemayehu Toma Mena, Tamirat Tesfaye Dasa, Abdur Razzaque Sarker, Andre M. N. Renzaho, Muhammad Aziz Rahman, Ali Kabir, Josephine W. Ngunjiri, Aberash Abay Tassew, Kala M. Mehta, Ionut Negoi, Hosni Salem, Hesham M. Al-Mekhlafi, Sharareh Eskandarieh, Rufus A. Adedoyin, Saleem M Rana, Engida Yisma, Sahel Valadan Tahbaz, Hossein Farzam, Krishna K. Aryal, Lalit Dandona, Masoud Moradi, Juan Sanabria, Gebre Teklemariam Demoz, Naser Mohammad Gholi Mezerji, Shirin Djalalinia, Suraj Bhattarai, Ammas Siraj Mohammed, Claudiu Herteliu, Dawit Zewdu Wondafrash, Mohsen Bayati, Arvin Haj-Mirzaian, Gulfaraz Khan, Mostafa Leili, Nasir Salam, Ehsan Khodamoradi, Jean Jacques Noubiap, Vahid Alipour, Mohammad Ali Mansournia, Rajesh Sagar, Jagadish Rao Padubidri, Manasi Kumar, Mehdi Sharif, Fatemeh Heydarpour, Navid Rabiee, Gvs Murthy, Hamed Kalani, Mayowa O. Owolabi, Claudio Alberto Davila, Oluchi Okpala, Shivakumar K.M. Kondlahalli, Mathew M. Baumann, Bereket Duko Adema, Lorenzo Monasta, Paul S. F. Yip, Mohammad Hossein Khosravi, Rizwan Suliankatchi Abdulkader, Ibrahim Abdollahpour, Dhirendra N Sinha, Farid Najafi, Kebede Deribe, Paula Moraga, Mehedi Hasan, Mohammad Moradi-Joo, Melkamu Merid Mengesha, Temesgen Yihunie Akalu, Vishnu Renjith, Syed Mohamed Aljunid, Zemenu Tadesse Tessema, Amir Radfar, Nuno Taveira, Masoud Foroutan, Demelash Abewa Elemineh, Chinwe Juliana Iwu, Kamarul Imran Musa, Getaneh Alemu Abebe, Farshad Pourmalek, Olatunde Aremu, Mohammad Reza Salahshoor, Derrick A Bennett, Ahmad Daryani, Alebachew Fasil Ashagre, Apurba Shil, Narayan Bahadur Mahotra, Nelson J. Alvis-Zakzuk, Lauren E. Schaeffer, Alexandre C. Pereira, Mehdi Naderi, Mehdi Hosseinzadeh, Rovshan Khalilov, Ai Koyanagi, Salman Khazaei, Jennifer Rickard, Ali Almasi, Sandra B. Munro, Carlos Zambrana-Torrelio, Naohiro Yonemoto, Ahmad Ghashghaee, Real World Studies in PharmacoEpidemiology, -Genetics, -Economics and -Therapy (PEGET), Value, Affordability and Sustainability (VALUE), Microbes in Health and Disease (MHD), Instituto de Saúde Pública da Universidade do Porto, Local Burden Dis Diarrhoea, Department of Earth Observation Science, UT-I-ITC-ACQUAL, Faculty of Geo-Information Science and Earth Observation, GeoHealth, Reiner, Robert C, Wiens, Kirsten E, Deshpande, Aniruddha, Baumann, Mathew M, Adema, Bereket Duko, Yirsaw, Biruck Desalegn, Yisma, Engida, Hay, Simon I, Local Burden of Disease Diarrhoea Collaborators, Tampere University, Health Sciences, University of Helsinki, Institute for Molecular Medicine Finland, Clinicum, HUS Comprehensive Cancer Center, Local Burden of Disease Diarrhoea Collaborator, and Violante FS

Subjects
Low income countries, medicine.medical_treatment, 030204 cardiovascular system & hematology, Global Health, THERAPY, Global Burden of Disease, 0302 clinical medicine, Prevalence, Global health, Medicine, WATER, 030212 general & internal medicine, Children, 11 Medical and Health Sciences, Incidence, Mortality rate, Incidence (epidemiology), 1. No poverty, General Medicine, 3142 Public health care science, environmental and occupational health, Diarrhoea, 3. Good health, Child, Preschool, Middle income countries, A990 Medicine and Dentistry not elsewhere classified, TERRITORIES, Life Sciences & Biomedicine, Infants, Diarrhea, AFRICA, medicine.medical_specialty, Childhood deaths, RJ, sanitation, Developing country, Childhood diarrhoeal morbidity, ITC-HYBRID, 03 medical and health sciences, Medicine, General & Internal, General & Internal Medicine, Environmental health, SYSTEMATIC ANALYSIS, Life Science, Humans, Healthcare Disparities, Oral rehydration therapy, Risk factor, hand washing, Developing Countries, Disease burden, Global Nutrition, Wereldvoeding, Science & Technology, SEX-SPECIFIC MORTALITY, business.industry, CHOLERA, Public health, Bayes Theorem, diarrheal disease, Local Burden of Disease Diarrhoea Collaborators, ITC-ISI-JOURNAL-ARTICLE, NA, Human medicine, Diarrea, business
Abstract

Background: Across low-income and middle-income countries (LMICs), one in ten deaths in children younger than 5 years is attributable to diarrhoea. The substantial between-country variation in both diarrhoea incidence and mortality is attributable to interventions that protect children, prevent infection, and treat disease. Identifying subnational regions with the highest burden and mapping associated risk factors can aid in reducing preventable childhood diarrhoea. Methods: We used Bayesian model-based geostatistics and a geolocated dataset comprising 15 072 746 children younger than 5 years from 466 surveys in 94 LMICs, in combination with findings of the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2017, to estimate posterior distributions of diarrhoea prevalence, incidence, and mortality from 2000 to 2017. From these data, we estimated the burden of diarrhoea at varying subnational levels (termed units) by spatially aggregating draws, and we investigated the drivers of subnational patterns by creating aggregated risk factor estimates. Findings: The greatest declines in diarrhoeal mortality were seen in south and southeast Asia and South America, where 54·0% (95% uncertainty interval [UI] 38·1-65·8), 17·4% (7·7-28·4), and 59·5% (34·2-86·9) of units, respectively, recorded decreases in deaths from diarrhoea greater than 10%. Although children in much of Africa remain at high risk of death due to diarrhoea, regions with the most deaths were outside Africa, with the highest mortality units located in Pakistan. Indonesia showed the greatest within-country geographical inequality; some regions had mortality rates nearly four times the average country rate. Reductions in mortality were correlated to improvements in water, sanitation, and hygiene (WASH) or reductions in child growth failure (CGF). Similarly, most high-risk areas had poor WASH, high CGF, or low oral rehydration therapy coverage. Interpretation: By co-analysing geospatial trends in diarrhoeal burden and its key risk factors, we could assess candidate drivers of subnational death reduction. Further, by doing a counterfactual analysis of the remaining disease burden using key risk factors, we identified potential intervention strategies for vulnerable populations. In view of the demands for limited resources in LMICs, accurately quantifying the burden of diarrhoea and its drivers is important for precision public health. This work was primarily supported by a grant from the Bill & Melinda Gates Foundation (OPP1132415). S Aljunid reports additional funding from the International Centre for Casemix and Clinical Coding, Faculty of Medicine, National University of Malaysia and Department of Health Policy and Management, Faculty of Public Health, Kuwait University for the approval and support to participate in this research project outside of the study. A Awasthi is supported by the Department of Science and Technology, Government of India, New Delhi, through the INSPIRE Faculty Program outside of the study. A Badawi reports additional funding from the Public Health Agency of Canada outside of the study. A Barac reports additional funding from the Project of Ministry of Education, Science and Technology of the Republic of Serbia (no III45005) outside of the study. T Bärnighausen reports additional funding by the Alexander von Humboldt Foundation through the Alexander von Humboldt Professor award, funded by the German Federal Ministry of Education and Research outside of the study. F Carvalho and E Fernandez report additional funding from the Portuguese national funds (UID/MULTI/04378/2019 and UID/QUI/50006/2019) outside of the study. V M Costa reports additional funding from Fundação da Ciência e Tecnologia (FCT) for her grant (SFRH/BPD/110001/2015), which was funded by national funds through FCT – Fundação para a Ciência e a Tecnologia, IP, under the Norma Transitória – DL57/2016/CP1334/CT0006 outside of the study. J De Neve reports additional funding from the Alexander von Humboldt Foundation outside of the study. K Deribe reports additional funding from the Wellcome Trust (grant number 201900) as part of his International Intermediate Fellowship outside of the study. D Endalew and M Moradi report additional funding from Wolkite University. M Ausloos, C Herteliu, and A Pana report additional funding from the Romanian National Authority for Scientific Research and Innovation, CNDS-UEFISCDI (project number PN-III-P4-ID-PCCF-2016-0084) outside of the study. C Herteliu reports additional funding from the European Fund for Regional Development through Operational Program for Competitiveness (Project ID P_40_382) and the European Fund for Regional Development, through InterReg Romania-Hungary (project code EMS ROHU 217) outside of the study. P Hoogar reports additional funding from the Centre for Holistic Development and Research (CHDR), Kalaghatagi and The Department of Studies in Anthropology, Karnatak University, D S Islam reports additional funding from the National Heart Foundation of Australia and the Institute for Physical Activity and Nutrition, Deakin University outside of the study. A Khatony reports additional funding from the Clinical Research Development Center of Imam Reza Hospital in Kermanshah outside of the study. J Khubchandani reports additional funding from Merck Research Laboratories outside of the study. K Krishan reports additional funding from the UGC Center of Advanced Study (CAS II) awarded to the Department of Anthropology, Panjab University, Chandigarh, India outside of the study. M Kumar reports additional funding from the Fogarty Foundation/NIH through a K43 award (TW010716-01A1) outside of the study. B Lacey reports additional funding from the National Institute for Health Research Oxford Biomedical Research Centre and the British Heart Foundation Centre of Research Excellence (Oxford, UK) outside of the study. A M Samy reports additional funding from the Egyptian Fulbright Mission Program (EFMP) outside of the study. S Seyedmousavi reports additional funding from the Intramural Program of National Institute of Health Clinical Center, Bethesda, MD, USA outside of the study. M Shey reports additional funding from the Wellcome Trust Kenji Shibuya reports additional funding from Japan's Ministry of Health, Labour and Welfare and Japan's Ministry of Education, Culture, Sport, Science and Technology outside of the study. M Sobhiyeh reports additional funding from the Clinical Research Development Center of Imam Reza Hospital, Kermanshah University of Medical Sciences outside of the study. J Soriano reports additional funding from Centro de Investigación en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III (ISCIII), Madrid, Spain outside of the study. N Taveira reports additional funding from the LIFE study (RIA2016MC-1615) of the European and Developing Countries Clinical Trials Partnership (EDCTP) program supported by the European Union outside of the study. B Unnikrishnan reports additional funding from the Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, India outside of the study. T Wijeratne reports additional funding from the Department of Medicine, Faculty of Medicine, University of Rajarata, Saliyapura, Sri Lanka outside of the study. C S Wiysonge reports additional funding from the South African Medical Research Council and the National Research Foundation of South Africa outside of the study.

Published
2020

45. Fuzzy Logic Based Control of Multilevel Inverter for Railway Traction System

Author

Jaydeep Lakwal, Manisha Dubey, and Blue Eyes Intelligence Engineering & Sciences Publication (BEIESP)

Subjects
Fuzzy logic controller, Multilevel Inverter, Electric Multiple Unit, Fuzzy Logic Controller, Asymmetric Cascaded H-bridge, Environmental Engineering, Control theory, Computer science, Multilevel inverter, Control (management), General Engineering, Traction system, 2249-8958, Fuzzy logic, C5609029320/2020©BEIESP, Computer Science Applications
Abstract

This research especially focus on Railway Traction System of Electrical Multiple Units (EMUs) and illustrate the approaching of an Asymmetric Cascaded H-bridge (ACHB) 9-level MLI controlled by the Fuzzy Logic Controller (FLC) to enhance the quality of output by sinking the harmonic contents in the output result. As in the railway, traction system desires high power and voltage for its operation. So it is proficient to utilize recent introduced Multilevel Inverter (MLI) instead of Conventional Inverter. MLI which is discussed here uses two H-bridge modules with unequal DC sources and it is competent to generate multilevel results at output side. Here proposed MLI uses limited semiconductor switches and voltage source. Therefore expenditure and dimensions of the system is condensed. Thus the system effectiveness will enhance. Simulation has done by MATLAB software to authenticate the performance and functional study of proposed MLI. The simulated output shows very favourable result. Comparison has been made between the two (Conventional and Multilevel) power circuit configurations.

Published
2020

46. Mapping disparities in education across low- and middle-income countries

Author

Lauren E. Schaeffer, Belay Tessema, Reza Malekzadeh, Olatunde Aremu, Mehdi Hosseinzadeh, Milena M Santric Milicevic, Seyyed Meysam Mousavi, Azeem Majeed, Badr Hasan Sobaih, Jalal Arabloo, Philimon Gona, Aliasghar Ahmad Kiadaliri, Mostafa Qorbani, Fatemeh Rajati, Ipsita Sutradhar, Giuseppe Remuzzi, Babak Eshrati, Olufemi Ajumobi, Lauren Woyczynski, Parul Puri, Vinay Nangia, Guoqing Hu, Yousef Khader, Suzanne Barker-Collo, Hamideh Salimzadeh, Félix Carvalho, Yun Jin Kim, Moslem Soofi, Ali Bijani, Shanshan Li, Catalina Liliana Andrei, Ali Kazemi Karyani, Mehran Asadi-Aliabadi, Andrea Sylvia Winkler, Arya Haj-Mirzaian, Maziar Moradi-Lakeh, Farnam Mohebi, Mohamad-Hani Temsah, Kala M. Mehta, Simon I. Hay, Benjamin B. Massenburg, Sanjay Zodpey, Tuomo J. Meretoja, Ireneous N. Soyiri, Bach Xuan Tran, George C Patton, Kavumpurathu Raman Thankappan, Engida Yisma, Vasily Vlassov, Samer Hamidi, Ghulam Mustafa, André Faro, Eduarda Fernandes, Chandrashekhar T Sreeramareddy, Rajat Gupta, Shirin Djalalinia, Dina Nur Anggraini Ningrum, Sheikh Mohammed Shariful Islam, Juan Sanabria, Leonardo Roever, Dayane Gabriele Alves Silveira, Samad Azari, Vahid Alipour, Gabrielle B. Britton, Luca Ronfani, Rosario Cárdenas, Maarten J. Postma, Hamid Yimam Hassen, Pn Sylaja, Brijesh Sathian, Paul S. F. Yip, Vegard Skirbekk, Chhabi Lal Ranabhat, Paramjit Gill, Walter Mendoza, Lorenzo Monasta, Dara K. Mohammad, Naznin Hossain, Dhirendra N Sinha, Ali H. Mokdad, Aziz Rezapour, Megan F. Schipp, Ziyad Al-Aly, Takeshi Fukumoto, Kebede Deribe, Paula Moraga, Mohammad Ebrahimi Kalan, Ai Koyanagi, Andre M. N. Renzaho, Cyrus Cooper, Ghobad Moradi, Ruth W Kimokoti, Swayam Prakash, Rafael Tabarés-Seisdedos, Zahra Jorjoran Shushtari, Zemenu Tadesse Tessema, Amir Radfar, Jean Jacques Noubiap, Emmanuela Gakidou, Mahdi Afshari, Suleman Atique, Reza Majdzadeh, Kiomars Sharafi, Seyed-Mohammad Fereshtehnejad, Foad Abd-Allah, Zahid A Butt, Beruk Berhanu Desalegn, Ruxandra Irina Negoi, Marek Majdan, Yoshan Moodley, Jianrong Zhang, Farid Najafi, Aso Mohammad Darwesh, Benn Sartorius, Amber Sligar, Nicole Davis Weaver, Naohiro Yonemoto, Jacob Olusegun Olusanya, Olayinka Stephen Ilesanmi, Neeraj Bedi, Suraj Bhattarai, Sadaf G. Sepanlou, Francisco Rogerlandio Martins-Melo, Malihe Nourollahpour Shiadeh, Bernardo Hernández Prado, Masood Ali Shaikh, Khalid A Altirkawi, Carlos Rios-Gonzalez, Claudiu Herteliu, Jason B. Hall, Irina Filip, Abdullah Sulieman Terkawi, Sojib Bin Zaman, Nathaniel J Henry, Eleonora Dubljanin, Jasvinder A. Singh, Pushpendra Kumar, Akram Pourshams, Jung-Chen Chang, Irfan Ullah, Lorainne Tudor Car, Franz Castro, George A. Mensah, Delia Hendrie, Mehran Shams-Beyranvand, Zulfiqar A Bhutta, Jaifred Christian F. Lopez, Laura Dwyer-Lindgren, Lee Ling Lim, Charles D.A. Wolfe, Adnan Kisa, Seyed Sina Naghibi Irvani, Alaa Badawi, Bolajoko O. Olusanya, Tomohide Yamada, Gholamreza Roshandel, Jonathan F. Mosser, Jose A. Garcia, Andre Rodrigues Duraes, Mohammadreza Amiresmaili, Krittika Bhattacharyya, Yuan-Pang Wang, Sebastian Vollmer, Felix Akpojene Ogbo, Birkneh Tilahun Tadesse, Mihajlo Jakovljevic, Songhomitra Panda-Jonas, Paul H. Lee, Michael Collison, Sanghamitra Pati, Aziz Sheikh, Kalkidan Hassen Abate, Anthony Barnett, Ejaz Ahmad Khan, Michael A. Cork, Meghnath Dhimal, Norberto Perico, Francesco Saverio Violante, Daniel N. Kiirithio, Ted R. Miller, Arundhati R. Sawant, Olalekan A. Uthman, Kewal Krishan, Ashish Awasthi, Anthony Masaka, Katherine F. Wilson, Padukudru Anand Mahesh, Roy Burstein, Amir Kasaeian, Yuming Guo, Peter Nyasulu, Chuanhua Yu, Pascual R. Valdez, Josephine W. Ngunjiri, Vipin Gupta, Tomislav Mestrovic, Long Hoang Nguyen, Neda Izadi, Faris Lami, Marcos Roberto Tovani-Palone, Azin Nahvijou, Jun She, Christopher J L Murray, Krishna K. Aryal, Payman Salamati, Mona M. Khater, Rajeev Gupta, Robert Reiner, Mustafa Z. Younis, Ali Rostami, Duduzile Ndwandwe, Obinna Onwujekwe, Manasi Kumar, Nafis Sadat, Nahla Anber, Joan B. Soriano, Victor Adekanmbi, John C. Wilkinson, Babak Moazen, Andrew T Olagunju, Nicholas Graetz, Andualem Henok, Mina Anjomshoa, Boris Bikbov, Melaku Desta, Yahya Safari, Jan-Walter De Neve, Carlos A Castañeda-Orjuela, Mohammad Fareed, Ayman Grada, Eduardo Ortiz-Panozo, Rajesh Sharma, Beatriz Paulina Ayala Quintanilla, Enrico Rubagotti, John S. Ji, Mika Shigematsu, Fakher Rahim, Randah R. Hamadeh, G. K. Mini, Yasir Waheed, Meghdad Pirsaheb, Yousef Veisani, Daniel Diaz, Adrian Pana, Salman Rawaf, Ehsan Sadeghi, Yahya Salimi, Joseph Adel Mattar Banoub, Carl Abelardo T. Antonio, Morteza Abdullatif Khafaie, David M. Pigott, Fares Alahdab, Vafa Rahimi-Movaghar, Anbissa Muleta Senbeta, Tomi Akinyemiju, Damaris K. Kinyoki, Morteza Shamsizadeh, Ziad El-Khatib, Abdallah M. Samy, Roman Topor-Madry, Farah Daoud, Cuong Tat Nguyen, Aubrey J. Levine, Sameer Vali Gopalani, Ravi Prakash Jha, Mesfin Tadese Dinberu, Shafiu Mohammed, Simon Øverland, David Laith Rawaf, Arvin Haj-Mirzaian, Satar Rezaei, Oladimeji Adebayo, Nasir Salam, Mohammad Ali Mansournia, Rajesh Sagar, Alex Yeshaneh, Michael K. Hole, Agus Sudaryanto, Yunquan Zhang, Mahbobeh Faramarzi, Natalia V. Bhattacharjee, Aniruddha Deshpande, Soewarta Kosen, Mahmoud Yousefifard, Jacek Jerzy Jozwiak, Mehedi Hasan, Shane D. Morrison, Erkin M. Mirrakhimov, Marcel Ausloos, Ionut Negoi, Jacqueline Elizabeth Alcalde Rabanal, Barthelemy Kuate Defo, Giang Thu Vu, Lucas Earl, Doris D. V. Ortega-Altamirano, Yu Liao, Peter Njenga Keiyoro, Tanuj Kanchan, Chandrasekharan Nair Kesavachandran, Mu'awiyyah Babale Sufiyan, Mohammad Hifz Ur Rahman, Lidia Morawska, Tiffany K. Gill, Manisha Dubey, David C. Schwebel, Jost B. Jonas, Ester Cerin, Mehran Alijanzadeh, Florian Fischer, Stefan Listl, Benjamin K. Mayala, Mahmood Moosazadeh, Soraya Siabani, Derrick A Bennett, Collaborators, Local Burden of Disease Educational Attainment, Institute for Molecular Medicine Finland, HUS Comprehensive Cancer Center, Clinicum, Helsinki University Hospital Area, University of Helsinki, Local Burden Dis Educ Attainment C, Graetz N., Woyczynski L., Wilson K.F., Hall J.B., Abate K.H., Abd-Allah F., Adebayo O.M., Adekanmbi V., Afshari M., Ajumobi O., Akinyemiju T., Alahdab F., Al-Aly Z., Rabanal J.E.A., Alijanzadeh M., Alipour V., Altirkawi K., Amiresmaili M., Anber N.H., Andrei C.L., Anjomshoa M., Antonio C.A.T., Arabloo J., Aremu O., Aryal K.K., Asadi-Aliabadi M., Atique S., Ausloos M., Awasthi A., Quintanilla B.P.A., Azari S., Badawi A., Banoub J.A.M., Barker-Collo S.L., Barnett A., Bedi N., Bennett D.A., Bhattacharjee N.V., Bhattacharyya K., Bhattarai S., Bhutta Z.A., Bijani A., Bikbov B., Britton G., Burstein R., Butt Z.A., Cardenas R., Carvalho F., Castaneda-Orjuela C.A., Castro F., Cerin E., Chang J.-C., Collison M.L., Cooper C., Cork M.A., Daoud F., Das Gupta R., Weaver N.D., De Neve J.-W., Deribe K., Desalegn B.B., Deshpande A., Desta M., Dhimal M., Diaz D., Dinberu M.T., Djalalinia S., Dubey M., Dubljanin E., Duraes A.R., Dwyer-Lindgren L., Earl L., Kalan M.E., El-Khatib Z., Eshrati B., Faramarzi M., Fareed M., Faro A., Fereshtehnejad S.-M., Fernandes E., Filip I., Fischer F., Fukumoto T., Garcia J.A., Gill P.S., Gill T.K., Gona P.N., Gopalani S.V., Grada A., Guo Y., Gupta R., Gupta V., Haj-Mirzaian A., Hamadeh R.R., Hamidi S., Hasan M., Hassen H.Y., Hendrie D., Henok A., Henry N.J., Prado B.H., Herteliu C., Hole M.K., Hossain N., Hosseinzadeh M., Hu G., Ilesanmi O.S., Irvani S.S.N., Islam S.M.S., Izadi N., Jakovljevic M., Jha R.P., Ji J.S., Jonas J.B., Shushtari Z.J., Jozwiak J.J., Kanchan T., Kasaeian A., Karyani A.K., Keiyoro P.N., Kesavachandran C.N., Khader Y.S., Khafaie M.A., Khan E.A., Khater M.M., Kiadaliri A.A., Kiirithio D.N., Kim Y.J., Kimokoti R.W., Kinyoki D.K., Kisa A., Kosen S., Koyanagi A., Krishan K., Defo B.K., Kumar M., Kumar P., Lami F.H., Lee P.H., Levine A.J., Li S., Liao Y., Lim L.-L., Listl S., Lopez J.C.F., Majdan M., Majdzadeh R., Majeed A., Malekzadeh R., Mansournia M.A., Martins-Melo F.R., Masaka A., Massenburg B.B., Mayala B.K., Mehta K.M., Mendoza W., Mensah G.A., Meretoja T.J., Mestrovic T., Miller T.R., Mini G.K., Mirrakhimov E.M., Moazen B., Mohammad D.K., Darwesh A.M., Mohammed S., Mohebi F., Mokdad A.H., Monasta L., Moodley Y., Moosazadeh M., Moradi G., Moradi-Lakeh M., Moraga P., Morawska L., Morrison S.D., Mosser J.F., Mousavi S.M., Murray C.J.L., Mustafa G., Nahvijou A., Najafi F., Nangia V., Ndwandwe D.E., Negoi I., Negoi R.I., Ngunjiri J.W., Nguyen C.T., Nguyen L.H., Ningrum D.N.A., Noubiap J.J., Shiadeh M.N., Nyasulu P.S., Ogbo F.A., Olagunju A.T., Olusanya B.O., Olusanya J.O., Onwujekwe O.E., Ortega-Altamirano D.D.V., Ortiz-Panozo E., Overland S., Mahesh P.A., Pana A., Panda-Jonas S., Pati S., Patton G.C., Perico N., Pigott D.M., Pirsaheb M., Postma M.J., Pourshams A., Prakash S., Puri P., Qorbani M., Radfar A., Rahim F., Rahimi-Movaghar V., Rahman M.H.U., Rajati F., Ranabhat C.L., Rawaf D.L., Rawaf S., Reiner R.C., Remuzzi G., Renzaho A.M.N., Rezaei S., Rezapour A., Rios-Gonzalez C., Roever L., Ronfani L., Roshandel G., Rostami A., Rubagotti E., Sadat N., Sadeghi E., Safari Y., Sagar R., Salam N., Salamati P., Salimi Y., Salimzadeh H., Samy A.M., Sanabria J., Santric Milicevic M.M., Sartorius B., Sathian B., Sawant A.R., Schaeffer L.E., Schipp M.F., Schwebel D.C., Senbeta A.M., Sepanlou S.G., Shaikh M.A., Shams-Beyranvand M., Shamsizadeh M., Sharafi K., Sharma R., She J., Sheikh A., Shigematsu M., Siabani S., Silveira D.G.A., Singh J.A., Sinha D.N., Skirbekk V., Sligar A., Sobaih B.H., Soofi M., Soriano J.B., Soyiri I.N., Sreeramareddy C.T., Sudaryanto A., Babale Sufiyan M., Sutradhar I., Sylaja P., Tabares-Seisdedos R., Tadesse B.T., Temsah M.-H., Terkawi A.S., Tessema B., Tessema Z.T., Thankappan K.R., Topor-Madry R., Tovani-Palone M.R., Tran B.X., Car L.T., Ullah I., Uthman O.A., Valdez P.R., Veisani Y., Violante F.S., Vlassov V., Vollmer S., Thu Vu G., Waheed Y., Wang Y.-P., Wilkinson J.C., Winkler A.S., Wolfe C.D.A., Yamada T., Yeshaneh A., Yip P., Yisma E., Yonemoto N., Younis M.Z., Yousefifard M., Yu C., Bin Zaman S., Zhang J., Zhang Y., Zodpey S., Gakidou E., Hay S.I., Graetz, Nicholas, Woyczynski, Lauren, Wilson, Katherine F, Hall, Jason B, Yisma, Engida, Hay, Simon I, Local Burden of Disease Educational Attainment Collaborators, Microbes in Health and Disease (MHD), Real World Studies in PharmacoEpidemiology, -Genetics, -Economics and -Therapy (PEGET), and Value, Affordability and Sustainability (VALUE)

Subjects
Male, ATTAINMENT, Health Status, Disease, education, low- and middle-income countries, 0302 clinical medicine, WORLD, gender, Global health, risk factors, 030212 general & internal medicine, Aetiology, 10. No inequality, media_common, Developing world, Pediatric, Multidisciplinary, 1. No poverty, Multidisciplinary Sciences, Geography, Science & Technology - Other Topics, Female, HEALTH, developing world, social and economic factors, Engineering sciences. Technology, disparitie, AFRICA, medicine.medical_specialty, Inequality, General Science & Technology, media_common.quotation_subject, MODELS, Developing country, Local Burden of Disease Educational Attainment Collaborators, Article, Healthcare improvement science Radboud Institute for Health Sciences [Radboudumc 18], Education, 03 medical and health sciences, 2.3 Psychological, medicine, Humans, Society, Social determinants of health, Developing Countries, Science & Technology, Equity (economics), MORTALITY, Public health, Bayes Theorem, Educational attainment, 3141 Health care science, society, Good Health and Well Being, Risk factors, Socioeconomic Factors, Demographic economics, 030217 neurology & neurosurgery
Abstract

Educational attainment is an important social determinant of maternal, newborn, and child health1–3. As a tool for promoting gender equity, it has gained increasing traction in popular media, international aid strategies, and global agenda-setting4–6. The global health agenda is increasingly focused on evidence of precision public health, which illustrates the subnational distribution of disease and illness7,8; however, an agenda focused on future equity must integrate comparable evidence on the distribution of social determinants of health9–11. Here we expand on the available precision SDG evidence by estimating the subnational distribution of educational attainment, including the proportions of individuals who have completed key levels of schooling, across all low- and middle-income countries from 2000 to 2017. Previous analyses have focused on geographical disparities in average attainment across Africa or for specific countries, but—to our knowledge—no analysis has examined the subnational proportions of individuals who completed specific levels of education across all low- and middle-income countries12–14. By geolocating subnational data for more than 184 million person-years across 528 data sources, we precisely identify inequalities across geography as well as within populations., Analyses of the proportions of individuals who have completed key levels of schooling across all low- and middle-income countries from 2000 to 2017 reveal inequalities across countries as well as within populations.

Published
2020

47. The global, regional, and national burden of inflammatory bowel disease in 195 countries and territories, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017

Author

Vahid Alipour, Amir Anushiravani, Saeid Safiri, Derrick Tsoi, Bach Xuan Tran, Ali Bijani, Mowafa Househ, Arya Haj-Mirzaian, Homayoon Vahedi, Molly R Nixon, Ali Reza Sima, Atif Amin Baig, Zeinab Sharafi, Shahin Merat, Hassan Abolhassani, Zhi-Jiang Zhang, Sonia Saxena, Tuomo J. Meretoja, Chi L Hoang, Jalal Arabloo, Jasvinder A. Singh, Lorenzo Monasta, Kevin Ikuta, Antonio Biondi, Akram Pourshams, Spencer L. James, Maryam Hashemian, Afshin Zarghi, Trang Huyen Nguyen, Amin Soheili, Félix Carvalho, Alaa Badawi, Aziz Eftekhari, Sudabeh Alatab, Nader Jafari Balalami, Amir Hasanzadeh, Antonio Maria Borzì, Andre Pascal Kengne, Luca Ronfani, Simon I. Hay, Berhe Etsay Tesfay, Arvin Haj-Mirzaian, Navid Rabiee, Reza Malekzadeh, Neeraj Bhala, Mohsen Naghavi, Sadaf G. Sepanlou, Kristin E Burke, Mehdi Sharif, Cuong Tat Nguyen, Marco Vacante, Erkin M. Mirrakhimov, Nima Rezaei, Amir Almasi-Hashiani, Ahmad Daryani, Ionut Negoi, David Laith Rawaf, Mohammad Rabiee, Hafiz Ansar Rasul Suleria, Ali H. Mokdad, Suleman Atique, Majid A Almadi, João C. Fernandes, Rasoul Sotoudehmanesh, Karzan Abdulmuhsin Mohammad, Hamid Reza Mirzaei, Masood Sepehrimanesh, Anahita Sadeghi, Eduarda Fernandes, Kiana Ramezanzadeh, Salman Rawaf, Florian Fischer, Manisha Dubey, Olayinka Stephen Ilesanmi, Stephen R. Robinson, Masood Ali Shaikh, Hossein Poustchi, Tomislav Mestrovic, Masoud M Malekzadeh, Soraya Siabani, Catherine Bisignano, Mae Dirac, Adam Belay Wondmieneh, Amir Abdoli, Ashish Awasthi, University of Helsinki, Clinicum, Staff Services, HUS Comprehensive Cancer Center, and Veritati - Repositório Institucional da Universidade Católica Portuguesa

Subjects
Adult, Male, medicine.medical_specialty, Population, IBD, Prevalence, Disease, Global Health, DIAGNOSIS, Global Burden of Disease, 03 medical and health sciences, 0302 clinical medicine, Cause of Death, Epidemiology, medicine, MANAGEMENT, Humans, EPIDEMIOLOGY, COHORT, education, POPULATION, Aged, Retrospective Studies, Cause of death, Aged, 80 and over, education.field_of_study, Hepatology, business.industry, Mortality rate, Gastroenterology, Bayes Theorem, Inflammatory Bowel Diseases, CROHNS-DISEASE, PREVALENCE, Survival Rate, Years of potential life lost, Socioeconomic Factors, ULCERATIVE-COLITIS, 030220 oncology & carcinogenesis, 3121 General medicine, internal medicine and other clinical medicine, Cohort, RISK-FACTORS, Female, 030211 gastroenterology & hepatology, Quality-Adjusted Life Years, Morbidity, business, Demography
Abstract

Background The burden of inflammatory bowel disease (IBD) is rising globally, with substantial variation in levels and trends of disease in different countries and regions. Understanding these geographical differences is crucial for formulating effective strategies for preventing and treating IBD. We report the prevalence, mortality, and overall burden of IBD in 195 countries and territories between 1990 and 2017, based on data from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2017. Methods We modelled mortality due to IBD using a standard Cause of Death Ensemble model including data mainly from vital registrations. To estimate the non-fatal burden, we used data presented in primary studies, hospital discharges, and claims data, and used DisMod-MR 2.1, a Bayesian meta-regression tool, to ensure consistency between measures. Mortality, prevalence, years of life lost (YLLs) due to premature death, years lived with disability (YLDs), and disability-adjusted life-years (DALYs) were estimated. All of the estimates were reported as numbers and rates per 100 000 population, with 95% uncertainty intervals (UI). Findings In 2017, there were 6.8 million (95% UI 6.4-7.3) cases of IBD globally. The age-standardised prevalence rate increased from 79.5 (75.9-83.5) per 100 000 population in 1990 to 84.3 (79.2-89.9) per 100 000 population in 2017. The age-standardised death rate decreased from 0.61 (0.55-0.69) per 100 000 population in 1990 to 0.51 (0.42-0.54) per 100 000 population in 2017. At the GBD regional level, the highest age-standardised prevalence rate in 2017 occurred in high-income North America (422.0 [398.7-446.1] per 100 000) and the lowest age-standardised prevalence rates were observed in the Caribbean (6.7 [6.3-7.2] per 100 000 population). High Sociodemographic Index (SDI) locations had the highest age-standardised prevalence rate, while low SDI regions had the lowest age-standardised prevalence rate. At the national level, the USA had the highest age-standardised prevalence rate (464.5 [438.6-490.9] per 100 000 population), followed by the UK (449.6 [420.6-481.6] per 100 000). Vanuatu had the highest age-standardised death rate in 2017 (1.8 [0.8-3.2] per 100 000 population) and Singapore had the lowest (0.08 [0.06-0.14] per 100 000 population). The total YLDs attributed to IBD almost doubled over the study period, from 0.56 million (0.39-0.77) in 1990 to 1.02 million (0.71-1.38) in 2017. The age-standardised rate of DALYs decreased from 26.5 (21.0-33.0) per 100 000 population in 1990 to 23.2 (19.1-27.8) per 100 000 population in 2017. Interpretation The prevalence of IBD increased substantially in many regions from 1990 to 2017, which might pose a substantial social and economic burden on governments and health systems in the coming years. Our findings can be useful for policy makers developing strategies to tackle IBD, including the education of specialised personnel to address the burden of this complex disease. Copyright (C) 2019 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license.

Published
2020

48. Design of Fuzzy-Logic Controller for Four-Switch 3-∅ Inverter Fed IM

Author

Suraj Marandi, Manisha Dubey, and Pankaj Swarnkar

Subjects
Fuzzy logic controller, Total harmonic distortion, Control algorithm, Vector control, Control theory, Computer science, Inverter, Induction motor
Abstract

In this study, the induction motor is fed by four-switch 3-phase (FSTP) inverter using the fuzzy-logic controller. The four-switch 3-phase inverter has some advantages over the conventional six-switch 3-phase inverter such as less complexity in control algorithm, low cost and less switching loss. The purpose of using the fuzzy-logic controller is to improve the speed response of the IM drive. In this study, the vector control method is utilized to control the induction motor. The purpose of this control approach is to minimize the THD, switching losses and complexity in control algorithm.

Published
2020

49. Quantifying risks and interventions that have affected the burden of diarrhoea among children younger than 5 years : an analysis of the Global Burden of Disease Study 2017

Author

Gessessew Bugssa Hailu, Arvin Haj-Mirzaian, Yuming Guo, Soewarta Kosen, Irfan Ullah, Khanh Bao Tran, Joan B. Soriano, Carl Abelardo T. Antonio, Teklay G E Teklu, Smita Pakhale, Dietrich Rothenbacher, Christopher Troeger, Eyasu Ejeta Duken, Erkin M. Mirrakhimov, Helena Manguerra, Cuong Tat Nguyen, Chalachew Genet Akal, Rakhi Dandona, Alaa Badawi, Barthelemy Kuate Defo, Sonali Kochhar, Javad Nazari, Evanson Z. Sambala, Nelson Alvis-Guzman, G Anil Kumar, Niranjan Kissoon, Yousef Veisani, Ai Koyanagi, Lalit Dandona, Molly R Nixon, David L. Smith, Samah Awad, Seyyed Meysam Mousavi, Rachel L Updike, Rajesh Kumar Rai, Hagos Tasew Atalay, Giuseppe Gorini, Charles Shey Wiysonge, Molly H Biehl, Zoubida Zaidi, Ahmad Daryani, Bach Xuan Tran, André Karch, Mostafa Qorbani, Zikria Saleem, Addisu Melese, Devasahayam J. Christopher, Adane Teshome Kefale, Félix Carvalho, Stephen S Lim, Birhanu Geta, Aziz Sheikh, Reginald Quansah, Andrew T Olagunju, Jalal Arabloo, Karzan Abdulmuhsin Mohammad, Fiseha Wadilo Wada, Amir Kasaeian, Maarten J. Postma, Abdullah T Khoja, Ravi Prakash Jha, Syed Mohamed Aljunid, Yousef Khader, Heather J. Zar, Ali Bijani, Ibrahim A Khalil, William M. Gardner, Marcia R. Weaver, Ebrahim M Yimer, Srinivas Murthy, Quique Bassat, Mu'awiyyah Babale Sufiyan, Kirsten E. Wiens, Saeed Amini, Ziad A. Memish, Samer Hamidi, Shanshan Li, Belay Tessema, Erlyn Rachelle King Macarayan, Tinuke O Olagunju, Alessandra C. Goulart, Seyed Sina Naghibi Irvani, Mahesh P A, Olatunde Aremu, Spencer L. James, Derrick A Bennett, Sezer Kisa, Keyghobad Ghadiri, Alireza Ahmadi, Theo Vos, Tuomo J. Meretoja, Mika Shigematsu, Naohiro Yonemoto, Shirin Djalalinia, Rakesh Lodha, Anselm Okoro, Adnan Kisa, Ali H. Mokdad, Aman Yesuf Endries, Josip Car, Fakher Rahim, Cheru Tesema Leshargie, Babak Moazen, Hamid Yimam Hassen, Lorenzo Monasta, Abdullah Al Mamun, Young-Ho Khang, Yasir Waheed, Mohamad-Hani Temsah, Zakir Hussain, Milena M Santric Milicevic, Abdallah M. Samy, Ejaz Ahmad Khan, Hmwe H Kyu, Afshin Zarghi, Monika Sawhney, Ghulam Mustafa, Samuel B. Albertson, Tomislav Mestrovic, Long Hoang Nguyen, Marek Majdan, Maysaa El Sayed Zaki, Mihaela Hostiuc, Desalegn Tadese Mengistu, Chi Linh Hoang, Christopher J L Murray, Nahla Anber, Seyedmojtaba Seyedmousavi, Maria Jesus Rios-Blancas, Mohammad Sadegh Rezai, Ashish Awasthi, Robert Reiner, Carlos A Castañeda-Orjuela, Shafiu Mohammed, Saeed Safari, Catrin E. Moore, Mina Anjomshoa, Joseph Adel Mattar Banoub, Fares Alahdab, Vafa Rahimi-Movaghar, Aniruddha Deshpande, Nicholas J Kassebaum, Kefyalew Addis Alene, Rajaa Al-Raddadi, Nancy Fullman, Benn Sartorius, Nuruzzaman Khan, Manisha Dubey, Eleonora Dubljanin, Stephanie R M Zimsen, Jost B. Jonas, Dharmesh Kumar Lal, Feleke Mekonnen Demeke, Jeffrey D. Stanaway, Euripide Frinel G Arthur Avokpaho, Tommi Vasankari, Florian Fischer, Krittika Bhattacharyya, Aleksandra Barac, Simon I. Hay, Kalpana Balakrishnan, Brigette F. Blacker, Eduarda Fernandes, Chandrashekhar T Sreeramareddy, Puja C Rao, Neeraj Bedi, Masood Ali Shaikh, Bartosz Miazgowski, Arya Haj-Mirzaian, Mohamed Lemine Cheikh brahim Ahmed, Vahid Alipour, Tesfaye Dessale Kassa, Luca Ronfani, Suleman Atique, Muhammad Imran Nisar, Alireza Rafiei, Aziz Rezapour, Ruth W Kimokoti, Noore Alam, Zulfiqar A Bhutta, Katherine Rosettie, Jonathan F. Mosser, Felix Akpojene Ogbo, Degu Abate, Clinicum, HUS Comprehensive Cancer Center, Staff Services, University of Helsinki, Department of Oncology, Public Health, Microbes in Health and Disease (MHD), Real World Studies in PharmacoEpidemiology, -Genetics, -Economics and -Therapy (PEGET), Value, Affordability and Sustainability (VALUE), Collaborators, GBD 2017 Diarrhoeal Disease, and GBD 2017 Diarrhoeal Dis

Subjects
Male, Diarrhea, AFRICA, 030231 tropical medicine, Developing country, Global Health, Risk Assessment, Global Burden of Disease, 03 medical and health sciences, MORBIDITY, Life Expectancy, 0302 clinical medicine, SDG 3 - Good Health and Well-being, SANITATION, NUTRITIONAL INTERVENTIONS, Environmental health, Prevalence, Global health, Humans, Medicine, 030212 general & internal medicine, Risk factor, Child, Developing Countries, Wasting, Children, Models, Statistical, business.industry, Mortality rate, MORTALITY, 1. No poverty, Infant, Verbal autopsy, 3. Good health, Infectious Diseases, Socioeconomic Factors, WATER-QUALITY, Child, Preschool, Relative risk, 3121 General medicine, internal medicine and other clinical medicine, Child Mortality, GROWTH, Female, Human medicine, medicine.symptom, business, Risk assessment, Diarrea, Infants
Abstract

Background Many countries have shown marked declines in diarrhoeal disease mortality among children younger than 5 years. With this analysis, we provide updated results on diarrhoeal disease mortality among children younger than 5 years from the Global Burden of Diseases, Injuries, and Risk Factors Study 2017 (GBD 2017) and use the study's comparative risk assessment to quantify trends and effects of risk factors, interventions, and broader sociodemographic development on mortality changes in 195 countries and territories from 1990 to 2017. Methods This analysis for GBD 2017 had three main components. Diarrhoea mortality was modelled using vital registration data, demographic surveillance data, and verbal autopsy data in a predictive, Bayesian, ensemble modelling tool; and the attribution of risk factors and interventions for diarrhoea were modelled in a counterfactual framework that combines modelled population-level prevalence of the exposure to each risk or intervention with the relative risk of diarrhoea given exposure to that factor. We assessed the relative and absolute change in diarrhoea mortality rate between 1990 and 2017, and used the change in risk factor exposure and sociodemographic status to explain differences in the trends of diarrhoea mortality among children younger than 5 years. Findings Diarrhoea was responsible for an estimated 533 768 deaths (95% uncertainty interval 477 162–593 145) among children younger than 5 years globally in 2017, a rate of 78·4 deaths (70·1–87·1) per 100 000 children. The diarrhoea mortality rate ranged between countries by over 685 deaths per 100 000 children. Diarrhoea mortality per 100 000 globally decreased by 69·6% (63·1–74·6) between 1990 and 2017. Among the risk factors considered in this study, those responsible for the largest declines in the diarrhoea mortality rate were reduction in exposure to unsafe sanitation (13·3% decrease, 11·2–15·5), childhood wasting (9·9% decrease, 9·6–10·2), and low use of oral rehydration solution (6·9% decrease, 4·8–8·4). Interpretation Diarrhoea mortality has declined substantially since 1990, although there are variations by country. Improvements in sociodemographic indicators might explain some of these trends, but changes in exposure to risk factors—particularly unsafe sanitation, childhood growth failure, and low use of oral rehydration solution—appear to be related to the relative and absolute rates of decline in diarrhoea mortality. Although the most effective interventions might vary by country or region, identifying and scaling up the interventions aimed at preventing and protecting against diarrhoea that have already reduced diarrhoea mortality could further avert many thousands of deaths due to this illness. Funding Bill & Melinda Gates Foundation.

Published
2020

50. Burden of injury along the development spectrum: associations between the Socio-demographic Index and disability-adjusted life year estimates from the Global Burden of Disease Study 2017

Author

Hassan Haghparast Bidgoli, Young Eun Kim, Duduzile Ndwandwe, Marilita M Moschos, Diego De Leo, Mark A. Stokes, Faris Lami, Lorenzo Monasta, Amit Arora, Hamid Asayesh, Dhirendra N Sinha, Ferrán Catalá-López, Ana Maria Nogales Vasconcelos, Swayam Prakash, Rafael Tabarés-Seisdedos, Melkamu Merid Mengesha, Yuichiro Yano, Olalekan A. Uthman, Amir Radfar, Manasi Kumar, Kamarul Imran Musa, Babak Moazen, Spencer L. James, Ahmad Daryani, Achala Upendra Jayatilleke, Siavash Rahimi, Carl Abelardo T. Antonio, Morteza Abdullatif Khafaie, Meysam Behzadifar, Dan J. Stein, Kathryn H. Jacobsen, Jiabin Shen, Rajesh Kumar Rai, Ehimario U. Igumbor, Amir Kasaeian, Ali Kabir, Morteza Shamsizadeh, Ziad El-Khatib, Sharareh Eskandarieh, Sorin Hostiuc, Jarnail Singh Thakur, Takeshi Fukumoto, Shai Linn, João Pedro Silva, Olayinka Stephen Ilesanmi, Gizachew Assefa Tessema, Naohiro Yonemoto, Jacek Jerzy Jozwiak, Masood Ali Shaikh, Seyyed Meysam Mousavi, Syed Mohamed Aljunid, Azeem Majeed, Alexandra Brazinova, Nader Jahanmehr, Yuming Guo, Sonia Saxena, Juanita A. Haagsma, Devasahayam J. Christopher, Lorainne Tudor Car, Shamsa Zafar, Roghayeh Mohammadibakhsh, Khanh Bao Tran, Reza Malekzadeh, Martha Híjar, Addisu Melese, Tinuke O Olagunju, Guoqing Hu, Yousef Khader, Olatunde Aremu, Yahya Salimi, Corina Benjet, Seyed-Mohammad Fereshtehnejad, Julio Cesar Campuzano Rincon, Rizwan Kalani, Bach Xuan Tran, Serge Resnikoff, Félix Carvalho, Suzanne Barker-Collo, Basema Saddik, Abraham Getachew Kelbore, Chris D Castle, Andre Pascal Kengne, Joan B. Soriano, Aliasghar Ahmad Kiadaliri, Derrick A Bennett, Pedro R. Olivares, Ali Bijani, Shanshan Li, Srinivas Murthy, Dragos Virgil Davitoiu, Farid Najafi, Seyed Sina Naghibi Irvani, Maziar Moradi-Lakeh, Adauto Martins Soares Filho, Vasily Vlassov, Alessandra C. Goulart, Alireza Ahmadi, Theo Vos, Heather Orpana, Narayan Bahadur Mahotra, Dillon O Sylte, Tuomo J. Meretoja, Ireneous N. Soyiri, Susan M Sawyer, Nauman Khalid, Louisa Degenhardt, Kebede Embaye Gezae, Ubai Alsharif, Richard C. Franklin, Shane D. Morrison, Randah R. Hamadeh, G. K. Mini, Naznin Hossain, Zachary V Dingels, Kate Dolan, Florian Fischer, Atte Meretoja, Yasir Waheed, Milena M Santric Milicevic, Ai Koyanagi, Sadaf G. Sepanlou, Manisha Dubey, Michael Phillips, Koustuv Dalal, Maysaa El Sayed Zaki, Elena Varavikova, Rahul Gupta, Rajaa Al-Raddadi, Sergey Soshnikov, David Laith Rawaf, Zoubida Zaidi, David C. Schwebel, Hassan Magdy Abd El Razek, Jost B. Jonas, Flávia Ribeiro Machado, Yoshan Moodley, Stefania Mondello, Nicholas L S Roberts, N. Bedi, Amrit Banstola, Yong Zhao, Vladimir I. 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Subjects
Epidemiology, burden of disease, descriptive epidemiology, epidemiology, ECONOMIC-DEVELOPMENT, 1106 Human Movement and Sports Sciences, Poison control, Global Health, Global Burden of Disease, 0302 clinical medicine, Quality-Adjusted Life Year, Global health, 030212 general & internal medicine, 10. No inequality, 1. No poverty, Burden of disease, DALYS, 3142 Public health care science, environmental and occupational health, ddc, 3. Good health, Descriptive epidemiology, Epidemiological transition, REGISTRATION, Disabled Person, Public Health, Human, medicine.medical_specialty, DEATHS, Adolescent, 1117 Public Health and Health Services, 03 medical and health sciences, Life Expectancy, Injury prevention, SYSTEMATIC ANALYSIS, medicine, Disability-adjusted life year, Disease burden, Estimation, burden of disease, descriptive epidemiology, epidemiology, MORTALITY, Public health, EPIDEMIOLOGIC TRANSITION, Public Health, Environmental and Occupational Health, 030208 emergency & critical care medicine, TRENDS, EXPECTANCY HALE, 1701 Psychology, Wounds and Injuries, Human medicine, Demography
Abstract

Incluye: Correction: Burden of injury along the development spectrum: associations between the Socio-demographic Index and disability-adjusted life year estimates from the Global Burden of Disease Study 2017. Inj Prev. 2020 Oct;26(Supp 1):i164. doi: 10.1136/injuryprev-2019-043296corr1. Epub 2020 Sep 28. PMID: 32989004 Background: The epidemiological transition of non-communicable diseases replacing infectious diseases as the main contributors to disease burden has been well documented in global health literature. Less focus, however, has been given to the relationship between sociodemographic changes and injury. The aim of this study was to examine the association between disability-adjusted life years (DALYs) from injury for 195 countries and territories at different levels along the development spectrum between 1990 and 2017 based on the Global Burden of Disease (GBD) 2017 estimates. Methods: Injury mortality was estimated using the GBD mortality database, corrections for garbage coding and CODEm-the cause of death ensemble modelling tool. Morbidity estimation was based on surveys and inpatient and outpatient data sets for 30 cause-of-injury with 47 nature-of-injury categories each. The Socio-demographic Index (SDI) is a composite indicator that includes lagged income per capita, average educational attainment over age 15 years and total fertility rate. Results: For many causes of injury, age-standardised DALY rates declined with increasing SDI, although road injury, interpersonal violence and self-harm did not follow this pattern. Particularly for self-harm opposing patterns were observed in regions with similar SDI levels. For road injuries, this effect was less pronounced. Conclusions: The overall global pattern is that of declining injury burden with increasing SDI. However, not all injuries follow this pattern, which suggests multiple underlying mechanisms influencing injury DALYs. There is a need for a detailed understanding of these patterns to help to inform national and global efforts to address injury-related health outcomes across the development spectrum. Funding for GBD 2017 was provided by the Bill and Melinda Gates Foundation. Sí

Published
2020

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